Updated on 2025/08/22

写真a

 
YAMAKAGE Michiaki
 
Organization
School of Medicine Department of Anesthesiology Professor
Title
Professor
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Degree

  • Ph.D. (Medical)

Research Interests

  • 呼吸 吸入麻酔薬 血液凝固線溶 体温管理 統計 医学教育

Research Areas

  • Life Science / Anesthesiology

Education

  • Sapporo Medical University Postgraduate School of Medicine

    - 1993.3

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    Country: Japan

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  • Sapporo Medical University

    - 1988.3

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Professional Memberships

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Papers

  • Gut Microbiota Influences Developmental Anesthetic Neurotoxicity in Neonatal Rats. International journal

    Tomohiro Chaki, Yuri Horiguchi, Shunsuke Tachibana, Satoshi Sato, Tomoki Hirahata, Noriaki Nishihara, Natsumi Kii, Yusuke Yoshikawa, Kengo Hayamizu, Michiaki Yamakage

    Anesthesia and analgesia   2025.2

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    BACKGROUND: Anesthetic exposure during childhood is significantly associated with impairment of neurodevelopmental outcomes; however, the causal relationship and detailed mechanism of developmental anesthetic neurotoxicity remain unclear. Gut microbiota produces various metabolites and influences the brain function and development of the host. This relationship is referred to as the gut-brain axis. Gut microbiota may influence developmental anesthetic neurotoxicity caused by sevoflurane exposure. This study investigated the effect of changes in the composition of gut microbiota after fecal microbiota transplantation on spatial learning disability caused by developmental anesthetic neurotoxicity in neonatal rats. METHODS: Neonatal rats were allocated into the Control (n = 10) and Sevo (n = 10) groups in Experiment 1 and the Sevo (n = 20) and Sevo+FMT (n = 20) groups in Experiment 2, according to the randomly allocated mothers' group. The rats in Sevo and Sevo+FMT groups were exposed to 2.1% sevoflurane for 2 hours on postnatal days 7 to 13. Neonatal rats in the Sevo+FMT group received fecal microbiota transplantation immediately after sevoflurane exposure on postnatal days 7 to 13. The samples for fecal microbiota transplantation were obtained from nonanesthetized healthy adult rats. Behavioral tests, including Open field, Y-maze, Morris water maze, and reversal Morris water maze tests, were performed to evaluate spatial learning ability on postnatal days 26 to 39. RESULTS: Experiment 1 revealed that sevoflurane exposure significantly altered the gut microbiota composition. The relative abundance of Roseburia (effect value: 1.01) and Bacteroides genus (effect value: 1.03) increased significantly after sevoflurane exposure, whereas that of Lactobacillus (effect value: -1.20) decreased significantly. Experiment 2 revealed that fecal microbiota transplantation improved latency to target (mean ± SEM; Sevo group: 9.7 ± 8.2 seconds vs, Sevo+FMT group: 2.7 ± 2.4 seconds, d=1.16, 95% confidence interval: -12.7 to -1.3 seconds, P = .019) and target zone crossing times (Sevo group: 2.4 ± 1.6 vs, Sevo+FMT group: 5.4 ± 1.4, d=1.99, 95% confidence interval: 2.0-5.0, P < .001) in the reversal Morris water maze test. Microbiota analysis revealed that the α-diversity of gut microbiota increased after fecal microbiota transplantation. Similarly, the relative abundance of the Firmicutes phylum (effect value: 1.44), Ruminococcus genus (effect value: 1.69), and butyrate-producing bacteria increased after fecal microbiota transplantation. Furthermore, fecal microbiota transplantation increased the fecal concentration of butyrate and induced histone acetylation and the mRNA expression of brain-derived neurotrophic factor in the hippocampus, thereby suppressing neuroinflammation and neuronal apoptosis. CONCLUSIONS: The alternation of gut microbiota after fecal microbiota transplantation influenced spatial learning ability in neonatal rats with developmental anesthetic neurotoxicity. Modulation of the gut microbiota may be an effective prophylaxis for developmental anesthetic neurotoxicity in children.

    DOI: 10.1213/ANE.0000000000007410

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  • Ultrasound-assisted middle thoracic epidural catheter placement utilizing the most dorsal sites of bilateral transverse process roots as anatomical landmarks: A cadaveric observational study and a clinical randomized controlled trial. International journal

    Tatsuya Kunigo, Yusuke Yoshikawa, Shunichi Niki, Masahiro Ohtani, Mami Muraki, Asako Nitta, Yuki Ohsaki, Kanna Nagaishi, Michiaki Yamakage

    Journal of clinical anesthesia   101   111740 - 111740   2025.1

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    STUDY OBJECTIVE: We developed an innovative method for ultrasound-assisted thoracic epidural catheter placement and assessed its potential to reduce procedural duration for trainees. DESIGN: A cadaveric observational study and a clinical randomized controlled trial. SETTING: Sapporo Medical University Hospital. PATIENTS: A total of 52 adult patients scheduled for thoracic or abdominal surgery and four cadavers. INTERVENTIONS: Patients were randomly assigned to either group receiving conventional palpation (conventional group) or combination of the ultrasound examination and conventional palpation (ultrasound group). MEASUREMENTS: The primary outcome was total procedure time (sum of skin marking time and needling time) by trainees. The secondary outcomes were (1) skin marking time, (2) needling time, (3) multiple skin punctures, (4) needle redirection, (5) complications, and (6) failed cases. MAIN RESULTS: Through dissection of four cadavers, the most dorsal site of the transverse process root was identifiable by ultrasound and the reliable indicator of the interlaminar space. We devised ultrasound-assisted middle thoracic epidural catheter placement utilizing the most dorsal sites of bilateral transverse process roots as anatomical landmarks. Trainees in the ultrasound group had significantly longer skin marking time and significantly shorter needling time than those in the conventional group (107 [87-158] vs 46 s [34-54] s, p < 0.001 and 197 [156-328] vs 341 [303-488] s, p = 0.003). Consequently, there was no significant difference between the two groups in total procedure time (326 [263-467] s vs 391 [354-533] s, p = 0.167). Moreover, the probability of trainee failure in epidural anesthesia was significantly lower in the ultrasound group (2/26 [17.7 %] vs 10/26 [38.5 %], p = 0.019). CONCLUSIONS: Our novel technique for thoracic epidural catheter placement resulted in expedited needling and enhanced success rates among trainees, although there was no significant difference between total procedure time when using ultrasound guidance and that when using conventional palpation.

    DOI: 10.1016/j.jclinane.2024.111740

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  • Differences in circulating blood volume changes during emergence from general anesthesia in transcatheter aortic valve implantation and MitraClip implantation.

    Makishi Maeda, Yusuke Yoshikawa, Sho Ohno, Tomohiro Chaki, Michiaki Yamakage

    Journal of anesthesia   38 ( 4 )   489 - 495   2024.8

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    PURPOSE: We aimed to compare changes in the circulating blood volume (CBV) during emergence from general anesthesia in patients undergoing transcatheter aortic valve implantation (TAVI) and MitraClip implantation. METHOD: We included 97 patients who underwent TAVI or MitraClip implantation. The primary outcome was the rate of change in the estimated CBV associated with emergence from general anesthesia. The secondary outcomes were hemoglobin and hematocrit values before and after emergence from anesthesia for each procedure. Additionally, the independent factors associated with changes in the estimated CBV were assessed using multiple regression analysis. RESULTS: In the TAVI group, the hemoglobin concentration increased from 9.6 g/dL before emergence from anesthesia to 10.8 g/dL after emergence (P < 0.001; mean difference, 1.2 g/dL, 95% confidence interval [CI] 1.1-1.3 g/dL). Conversely, no statistically significant change was observed in the hemoglobin concentration before and after emergence from anesthesia in the MitraClip group. The mean rate of change in the estimated CBV was - 15.4% (standard deviation [SD] 6.4%) in the TAVI group and - 2.4% (SD, 4.7%) in the MitraClip group, indicating a significant decrease in the estimated CBV in the former than in the latter (P < 0.001; mean difference, 13.0%; 95% CI 9.9-16.1%). CONCLUSION: Emergence from general anesthesia increased the hemoglobin concentration and decreased the estimated CBV in patients undergoing TAVI but did not elicit significant changes in patients undergoing MitraClip implantation. These results may provide a rationale for minimizing blood transfusions during general anesthesia in patients undergoing these procedures.

    DOI: 10.1007/s00540-024-03345-1

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  • INJEX50 could improve the success rate of local anesthesia for arterial cannulation in the pediatric intensive care unit: A randomized, double-blind, single-center study. International journal

    Wataru Sakai, Tomohiro Chaki, Shunsuke Tachibana, Yuki Ichisaka, Yuko Nawa, Tomohiro Nawa, Michiaki Yamakage

    Paediatric anaesthesia   2024.5

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    BACKGROUND: Quick arterial cannulation is required in pediatric emergency situation, which require effective local anesthesia to avoid withdrawal movement. However, pediatric local anesthesia could be difficult because of withdrawal movement. Jet injectors, which are needleless and provide local anesthesia quickly, could be helpful for pediatric local anesthesia during arterial cannulation. AIMS: This study aimed to examine whether new jet injector "INJEX50" could improve the success rate of local anesthesia for arterial cannulation in pediatric intensive care unit compared with the current standard of care, infiltration using a 26-gauge needle. METHODS: This study was a randomized, double-blind, single-center study. Participants were infants and young children in the pediatric intensive care unit, who required an arterial line. Local anesthesia was performed with either a 26-gauge needle (group C) or INJEX50 (group I) before arterial cannulation. The primary outcome (success of local anesthesia) was the presence of withdrawal movement at the time of skin puncture for arterial cannulation. The secondary outcomes included rescue sedation during arterial cannulation. Data were analyzed using Fisher's exact test and the Mann-Whitney U-test, with values of p < .05 considered statistically significant. RESULTS: Seventy patients were randomly assigned to groups C and I. The local anesthesia success rate in group I (30/35 [86%]) was significantly higher than that in group C (15/35 [43%], odds ratio, 8.00; 95% confidence interval, 2.51-25.5; p = .0005). In conclusion, INJEX50 could improve success rate of local anesthesia for arterial cannulation in pediatric intensive care unit compared with 26-gauge needle.

    DOI: 10.1111/pan.14940

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  • Effect of using hypotension prediction index versus conventional goal-directed haemodynamic management to reduce intraoperative hypotension in non-cardiac surgery: A randomised controlled trial. International journal

    Yusuke Yoshikawa, Makishi Maeda, Tatsuya Kunigo, Tomoe Sato, Kanako Takahashi, Sho Ohno, Tomoki Hirahata, Michiaki Yamakage

    Journal of clinical anesthesia   93   111348 - 111348   2024.5

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    STUDY OBJECTIVE: It remains unclear whether it is the hypotension prediction index itself or goal-directed haemodynamic therapy that mitigates intraoperative hypotension. DESIGN: A single centre randomised controlled trial. SETTING: Sapporo Medical University Hospital. PATIENTS: A total of 64 adults patients undergoing major non-cardiac surgery under general anaesthesia. INTERVENTIONS: Patients were randomly assigned to either group receiving conventional goal-directed therapy (FloTrac group) or combination of the hypotension prediction index and conventional goal-directed therapy (HPI group). To investigate the independent utility of the index, the peak rates of arterial pressure and dynamic arterial elastance were not included in the treatment algorithm for the HPI group. MEASUREMENTS: The primary outcome was the time-weighted average of the areas under the threshold. Secondary outcomes were area under the threshold, the number of hypotension events, total duration of hypotension events, mean mean arterial pressure during the hypotension period, number of hypotension events with mean arterial pressure < 50 mmHg, amounts of fluids, blood products, blood loss, and urine output, frequency and amount of vasoactive agents, concentration of haemoglobin during the monitoring period, and 30-day mortality. MAIN RESULTS: The time-weighted average of the area below the threshold was lower in the HPI group than in the control group; 0.19 mmHg (interquartile range, 0.06-0.80 mmHg) vs. 0.66 mmHg (0.28-1.67 mmHg), with a median difference of -0.41 mmHg (95% confidence interval, -0.69 to -0.10 mmHg), p = 0.005. Norepinephrine was administered to 12 (40%) and 5 (17%) patients in the HPI and FloTrac groups, respectively (p = 0.045). No significant differences were observed in the volumes of fluid and blood products between the study groups. CONCLUSIONS: The current randomised controlled trial results suggest that using the hypotension prediction index independently lowered the cumulative amount of intraoperative hypotension during major non-cardiac surgery.

    DOI: 10.1016/j.jclinane.2023.111348

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  • Comparison of the negative effect of remimazolam and propofol on cardiac contractility: Analysis of a randomised parallel-group trial and a preclinical ex vivo study. International journal

    Yusuke Yoshikawa, Shunsuke Oura, Masatoshi Kanda, Tomohiro Chaki, Naoyuki Hirata, Mitsutaka Edanaga, Michiaki Yamakage

    Clinical and experimental pharmacology & physiology   51 ( 3 )   e13840   2024.3

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    Remimazolam is a newly developed ultra-short-acting benzodiazepine that exerts sedative effects. This study aimed to clarify the effects of remimazolam on cardiac contractility. In a randomised-parallel group trial, haemodynamic parameters were compared between propofol (n = 11) and remimazolam (n = 12) groups during the induction of general anaesthesia in patients undergoing non-cardiac surgery. In a preclinical study, the direct effects of remimazolam on cardiac contractility were also evaluated using isolated rat hearts. RNA sequence data obtained from rat and human hearts were analysed to assess the expression patterns of the cardiac γ-aminobutyric acid type A (GABAA ) receptor subunits. In a clinical study, the proportional change of the maximum rate of arterial pressure rise was milder during the study period in the remimazolam group (propofol: -52.6 [10.2] (mean [standard deviation])% vs. remimazolam: -39.7% [10.5%], p = 0.007). In a preclinical study, remimazolam did not exert a negative effect on left ventricle developed pressure, whereas propofol did exert a negative effect after bolus administration of a high dose (propofol: -26.9% [3.5%] vs. remimazolam: -1.1 [6.9%], p < 0.001). Analysis of the RNA sequence revealed a lack of γ subunits, which are part of the major benzodiazepine binding site of the GABAA receptor, in rat and human hearts. These results indicate that remimazolam does not have a direct negative effect on cardiac contractility, which might contribute to its milder effect on cardiac contractility during the induction of general anaesthesia. The expression patterns of cardiac GABAA receptor subunits might be associated with the unique pharmacokinetics of benzodiazepines in the heart.

    DOI: 10.1111/1440-1681.13840

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  • Japanese Traditional Herbal Medicine, Rikkunshito, Partially Suppresses Inflammatory Responses in Myocardial Ischemia/Reperfusion Injury. International journal

    Tomoe Sato, Yasuaki Sawashita, Yusuke Yoshikawa, Michiaki Yamakage

    Cureus   16 ( 2 )   e54485   2024.2

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    INTRODUCTION: Myocardial ischemia/reperfusion (I/R) injury can cause additional damage to an ischemic myocardium, even after successful reperfusion therapy. Inflammation is a mechanism that exacerbates myocardial damage after I/R injury. Rikkunshito (RKT) is a traditional Japanese herbal medicine widely used to treat gastrointestinal symptoms. It attenuates inflammation and fibrosis in some diseases of the heart; however, it remains unclear whether RKT exerts cardioprotective effects against myocardial I/R injury. To elucidate this, we evaluated the effects of RKT pre-treatment by oral administration on the myocardium in a mouse model of in vivo I/R injury. METHODS: Mice were randomly assigned to a group receiving distilled water (DW) or one receiving RKT (1000 mg/kg/day) for 14 days orally. For each of the RKT and DW groups, a sham group, an I/R 2 h group, and an I/R 24 h group were created. On day 15, myocardial I/R surgery was performed. The left anterior descending coronary artery (LAD) was ligated for 30 min, and reperfusion time was set at 2 h or 24 h. The myocardial infarct size (IS) was measured after 2 h of reperfusion, and cardiac cytokine mRNA expression levels were evaluated by quantitative reverse transcription polymerase chain reaction (RT-PCR) after 2 h and 24 h of reperfusion. RESULTS: RKT pre-treatment significantly suppressed the cardiac mRNA expression level of interleukin-1β in the RKT-I/R 2 h group compared to the DW-I/R 2 h group (P < 0.05). Additionally, RKT significantly suppressed the mRNA expression levels of transforming growth factor-β compared to DW; the same result was obtained for the expression levels of interleukin-6. However, RKT did not reduce the IS or mRNA expression levels of the cardiac congestive markers natriuretic peptide a (NPPA) and natriuretic peptide b (NPPB). In addition, RKT did not alter the plasma concentration of ghrelin and sirtuin 1 (Sirt1), which have been reported to be stimulated by RKT. CONCLUSION: This study showed that pre-treatment of RKT for myocardial I/R injury partially suppressed inflammation-related cytokines. However, further studies are needed on the effect of RKT on the reduction of myocardial infarction size.

    DOI: 10.7759/cureus.54485

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  • Venoarterial extracorporeal membrane oxygenation for cardiopulmonary resuscitation: A retrospective study comparing the outcomes of fluoroscopy. International journal

    Soichi Tanaka, Shunsuke Tachibana, Takashi Toyohara, Hajime Sonoda, Michiaki Yamakage

    Heliyon   10 ( 2 )   e24565   2024.1

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    BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) using venoarterial extracorporeal membrane oxygenation is performed for out-of-hospital cardiac arrest; however, it is associated with a risk of several complications. OBJECTIVE: To investigate whether the fluoroscopy equipment was removed from the emergency department (ED) and whether it would be beneficial to transport the patient to the fluoroscopy room to reduce vascular complications without affecting the induction time. METHODS: This single-center, retrospective, before-and-after analysis was conducted at a tertiary emergency medical center and included 59 patients who underwent ECPR for out-of-hospital cardiac arrest between May 2017 and March 2022. The patients were divided into two groups: those who underwent cannulation in the ED without fluoroscopy (ED-ECPR group) and those who were transferred directly from the ED to the cardiac angiography room (ECPR call group). RESULTS: The rate of vascular complications associated with ECPR was significantly lower in the ECPR group than in the ED-ECPR group (40.6 % [14/32] vs. 10 % [2/20], respectively; p = 0.014). The duration from ED arrival to venoarterial extracorporeal membrane oxygenation initiation was similar in the two groups (median: 23.0 min in the ED-ECPR group vs. 25.5 min in the ECPR call group, p = 0.71). Results adjusted for confounding factors showed that performing ECPR under fluoroscopy was a consistent and independent element of vascular complication rates (adjusted odds ratio: 9.92, 95 % confidence interval: 2.04 to 81.2, p = 0.011). CONCLUSIONS: Fluoroscopy-guided ECPR can significantly reduce the incidence of vascular complications even if the ED and fluoroscopy room are far apart. However, no significant difference was observed in the time required to establish ECPR in the cardiac catheterization laboratories.

    DOI: 10.1016/j.heliyon.2024.e24565

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  • Comparing leak pressure of LMA® ProSeal™ versus i-gel® at head rotation: a randomized controlled trial. International journal

    Tomohiro Chaki, Masatsugu Koizumi, Shunsuke Tachibana, Tomomi Matsumoto, Tomoe Kumagai, Yuki Hashimoto, Michiaki Yamakage

    Canadian journal of anaesthesia = Journal canadien d'anesthesie   2023.11

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    PURPOSE: The effect of head rotation on supraglottic airway (SGA) oropharyngeal leak pressure (OPLP) has not been well elucidated. The aim of this study was to help clarify which SGA device provides higher OPLP at head-rotated position. METHODS: Patients who underwent elective surgery under general anesthesia were enrolled and randomly divided into laryngeal mask airway (LMA®) ProSeal™ and i-gel® groups. The allocated SGA device was inserted under anesthesia. The primary outcome was OPLP, and secondary outcomes were ventilation score, expiratory tidal volume, and maximum pressure under volume-controlled ventilation (VCV) with an inspiratory tidal volume of 10 mL·kg-1 ideal body weight and fibreoptic view of the vocal cords at 0°, 30°, and 60° head rotation. RESULTS: Data from 78 and 76 patients were analyzed in the LMA ProSeal and i-gel groups, respectively. The mean (standard deviation) OPLP of the LMA ProSeal was significantly higher than that of the i-gel at the 60° head-rotated position (LMA ProSeal, 20.4 [6.5] vs i-gel, 16.9 [7.8] cm H2O; difference in means, 3.6; adjusted 95% confidence interval, 0.5 to 6.6; adjusted P = 0.02, adjusted for six comparisons). The maximum pressure under VCV at 60° head rotation was significantly higher in the LMA ProSeal group than in the i-gel group. The expiratory tidal volume of the LMA ProSeal did not significantly change with head rotation and was significantly higher than that of the i-gel at 60° head rotation. Ventilation score, fibreoptic view of the vocal cords, and complications were not significantly different between the ProSeal and i-gel groups. CONCLUSIONS: The LMA ProSeal provides higher OPLP than the i-gel at a 60° head-rotated position under general anesthesia. TRIAL REGISTRATION: Japan Registry of Clinical Trials (https://jrct.niph.go.jp) (JRCT1012210043); registered 18 October 2021.

    DOI: 10.1007/s12630-023-02648-3

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  • 経鼻的経蝶形骨洞手術における気管チューブのカフ上吸引による誤嚥予防の試み

    熊谷 友絵, 立花 俊祐, 山蔭 道明

    日本臨床麻酔学会誌   43 ( 6 )   S270 - S270   2023.11

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  • I-gel Plus acts as a superior conduit for fiberoptic intubation than standard i-gel

    Tomohiro Chaki, Shunsuke Tachibana, Sho Kumita, Satoshi Sato, Tomoki Hirahata, Yuta Ikeshima, Yuki Ohsaki, Michiaki Yamakage

    Scientific Reports   13 ( 1 )   2023.10

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    Abstract

    The supraglottic airway (SGA) is widely used. I-gel Plus is a next-generation i-gel with some improvements, including facilitation of fiberoptic tracheal intubation (FOI). To compare the performance of i-gel Plus and standard i-gel as conduits for FOI, a Thiel-embalmed cadaveric study was conducted. Twenty-two anesthesiologists were enrolled as operators in Experiment 1. The i-gel Plus and standard i-gel were inserted into one cadaver, and the FOI was performed through each SGA. The primary outcome was time required for FOI. The secondary outcomes were the number of attempts and visual analog scale (VAS) score for difficulty in FOI. Moreover, fiberoptic views of the vocal cords in each SGA were assessed by an attending anesthesiologist using nine cadavers in Experiment 2. The percentage of glottic opening (POGO) score without fiberscope tip upward flexion and upward angle of the fiberscope tip to obtain a 100% POGO score were evaluated as secondary outcomes. The time for FOI through i-gel Plus was significantly shorter than that through standard i-gel (median (IQR), i-gel Plus: 30.3 (25.4–39.0) s, vs standard i-gel: 54.7 (29.6–135.0) s; median of differences, 24.4 s; adjusted 95% confidence interval, 3.0–105.7; adjusted P = 0.040). Although the number of attempts for successful FOI was not significantly different, the VAS score for difficulty in the i-gel Plus group was significantly lower (easier) than that in the standard i-gel group. Moreover, i-gel Plus required a significantly smaller upward angle of the fiberscope tip to obtain a 100% POGO score. FOI can be performed more easily using i-gel Plus than using standard i-gel because of the improved fiberoptic visibility of vocal cords.

    Other Link: https://www.nature.com/articles/s41598-023-45631-0

    DOI: 10.1038/s41598-023-45631-0

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  • Dexmedetomidine as a cardioprotective drug: a narrative review.

    Kanako Takahashi, Yusuke Yoshikawa, Masatoshi Kanda, Naoyuki Hirata, Michiaki Yamakage

    Journal of anesthesia   2023.9

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    Dexmedetomidine (DEX), a highly selective alpha2-adrenoceptors agonist, is not only a sedative drug used during mechanical ventilation in the intensive care unit but also a cardio-protective drug against ischemia-reperfusion injury (IRI). Numerous preclinical in vivo and ex vivo studies, mostly evaluating the effect of DEX pretreatment in healthy rodents, have shown the efficacy of DEX in protecting the hearts from IRI. However, whether DEX can maintain its cardio-protective effect in hearts with comorbidities such as diabetes has not been fully elucidated. Multiple clinical trials have reported promising results, showing that pretreatment with DEX can attenuate cardiac damage in patients undergoing cardiac surgery. However, evidence of the post-treatment effects of DEX in clinical practice remains limited. In this narrative review, we summarize the previously reported evidence of DEX-induced cardio-protection against IRI and clarify the condition of the hearts and the timing of DEX administration that has not been tested. With further investigations evaluating these knowledge gaps, the use of DEX as a cardio-protective drug could be further facilitated in the management of patients undergoing cardiac surgery and might be considered in a broader area of clinical settings beyond cardiac surgery, including patients with acute myocardial infarction.

    DOI: 10.1007/s00540-023-03261-w

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  • Albumin protects the ultrastructure of the endothelial glycocalyx of coronary arteries in myocardial ischemia-reperfusion injury in vivo. International journal

    Yasuaki Sawashita, Satoshi Kazuma, Yasuyuki Tokinaga, Kenichiro Kikuchi, Naoyuki Hirata, Yoshiki Masuda, Michiaki Yamakage

    Biochemical and biophysical research communications   666   29 - 35   2023.7

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    Myocardial ischemia-reperfusion (I/R) injury induces endothelial glycocalyx (GCX) degradation. Several candidate GCX-protective factors including albumin have been identified, few have been demonstrated in in vivo studies and most albumins used to date have been heterologous. Albumin is a carrier protein for sphingosine 1-phosphate (S1P), which has protective effects on the cardiovascular system. However, changes inhibited by albumin in the endothelial GCX structure in I/R in vivo via the S1P receptor has not been reported. In this study, we aimed to determine whether albumin prevents the shedding of endothelial GCX in response to I/R in vivo. Rats were divided into four groups: control (CON), I/R, I/R with albumin preload (I/R + ALB), and I/R + ALB with S1P receptor agonist fingolimod (I/R + ALB + FIN). FIN acts as an initial agonist of S1P receptor 1 and downregulates the receptor in an inhibitory manner. The CON and I/R groups received saline and I/R + ALB and I/R + ALB + FIN groups received albumin solution before left anterior descending coronary artery ligation. Our study used rat albumin. Shedding of endothelial GCX was evaluated in the myocardium by electron microscopy, and the concentration of serum syndecan-1 was measured. Thus, albumin administration maintained the structure of endothelial GCX and prevented shedding of endothelial GCX via the S1P receptor in myocardial I/R, and FIN annihilated the protective effect of albumin against I/R injury.

    DOI: 10.1016/j.bbrc.2023.04.110

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  • A case of safe airway management by fiber-optic nasotracheal intubation in general anesthesia in a pediatric patient with Hajdu-Cheney syndrome: a case report. International journal

    Atsushi Kokita, Tomohiro Chaki, Michiaki Yamakage

    JA clinical reports   9 ( 1 )   33 - 33   2023.6

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    BACKGROUND: Hajdu-Cheney syndrome (HCS) is an extremely rare disorder characterized by progressive acro-osteolysis. A unique facial structure and deformity of the cervical spine are associated with a difficult airway. Although several reports describe general anesthesia with orotracheal intubation for patients with HCS, there have been no reports of nasotracheal intubation with a risk of skull base fracture. We describe nasotracheal intubation for oral surgery in a patient with HCS. CASE PRESENTATION: A 13-year-old girl with HCS was scheduled for dental surgery. Preoperative computed tomography revealed no abnormalities including fractures in the skull base or cervical spine. After confirming a lack of vocal cord paralysis by bronchofiberscopic inspection from the nose, general anesthesia was induced with sevoflurane, remifentanil, and rocuronium. Fiber-optic nasotracheal intubation was successfully performed without complications such as depletion of oxygen saturation and massive epistaxis, and the surgery was completed uneventfully. She was discharged the day after surgery with no anesthesia-related complications. CONCLUSIONS: We were able to safely manage the airway of a patient with HCS by nasotracheal intubation under general anesthesia.

    DOI: 10.1186/s40981-023-00627-7

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  • 周術期心停止

    前田 真岐志, 平田 直之, 茶木 友浩, 山蔭 道明

    麻酔   72 ( 4 )   330 - 336   2023.4

  • Validity and Utility of Early Parameters in TEG6s Platelet Mapping to Assess the Coagulation Status During Cardiovascular Surgery With Cardiopulmonary Bypass. International journal

    Yusuke Yoshikawa, Makishi Maeda, Sho Ohno, Kanako Takahashi, Yasuaki Sawashita, Tomoki Hirahata, Yutaka Iba, Nobuyoshi Kawaharada, Mitsutaka Edanaga, Michiaki Yamakage

    Cureus   15 ( 4 )   e38044   2023.4

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    Background The aim of this retrospective observational study was to explore the early predictive parameters for maximum amplitudein the kaolin with heparinase (HKH) assay (MAHKH) of TEG6s Platelet Mapping in cardiovascular surgery including cardiopulmonary bypass (CPB) period. The relationship between each parameter of the assay and laboratory data was also assessed. Methods We included the patients who underwent TEG6s Platelet Mapping during cardiovascular surgery under CPB between November 2021 and May 2022. The correlation between MAHKH and the early parameters was assessed. The association between each parameter of Platelet Mapping and a combination of fibrinogen concentration > 150 mg/dL and platelet count > 100,000µL was also evaluated by the receiver operating characteristic (ROC) curve. Results In 23 patients who underwent TEG6s Platelet Mapping during the study period, 62 HKH assay data including 59 pairs of data (HKH assay and laboratory data) were analyzed. K and angle, but not R, were significantly correlated with MAHKH (r [95% CI]: -0.90 [-0.94, -0.83], p < 0.0001 for K, and 0.87 [0.79, 0.92], p < 0.0001 for angle). Furthermore, ROC curves suggested that these parameters predicted a combination of fibrinogen concentration > 150 mg/dL and platelet count > 100,000/µL with high accuracy. Similar results were confirmed in the heparinized blood samples obtained during CPB. Conclusion These findings suggest that not only MAKHK but also K and angle, which are early parameters in the HKH assay, provide clinically significant information that will facilitate rapid decision-making regarding coagulation strategies during cardiovascular surgery including the CPB period.

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  • 周術期心停止

    前田 真岐志, 平田 直之, 茶木 友浩, 山蔭 道明

    麻酔   72 ( 4 )   330 - 336   2023.4

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  • Cricothyrotomy for an Unexpected Cannot Intubate, Cannot Ventilate Situation for a Patient with Chronic Graft-Versus-Host Disease After Induction of General Anesthesia: A Case Report. International journal

    Soichi Tanaka, Shunsuke Tachibana, Keito Kusakabe, Keiko Wakasugi, Hajime Sonoda, Michiaki Yamakage

    The American journal of case reports   24   e938992   2023.2

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    BACKGROUND Chronic graft-versus-host disease (GVHD) is a major complication of hematopoietic stem cell transplantations. Due to fibrotic changes, patients with GVHD are at risk for difficult airway management. We encountered a case of chronic GVHD that went into a "cannot intubate, cannot ventilate" (CICV) condition after induction of general anesthesia and was managed using cricothyrotomy. CASE REPORT A 45-year-old man with uncontrolled chronic GVHD developed pneumothorax of the right lung. Thoracoscopic dissection of the adhesions, closure of the pneumostomy, and drainage under general anesthesia were planned. In the preoperative airway assessment, we concluded that using a video laryngoscope or endotracheal fiber would be sufficient to intubate the patient after sedation and that airway management after the loss of consciousness would not be difficult. Therefore, general anesthesia was induced by rapid induction; however, the patient developed difficult mask ventilation. Intubation was attempted via a video laryngoscope or bronchofiber but failed. Ventilating using a supraglottic instrument was difficult. The patient was evaluated to have a CICV condition. Thereafter, because of a rapid decrease in oxygen saturation (SpO2) and bradycardia, a cricothyrotomy was performed. Subsequently, ventilation became adequate, SpO2 increased immediately and drastically, and respiration and circulatory dynamics recovered. CONCLUSIONS We believe that anesthesiologists should practice, prepare, and simulate airway emergencies that can be experienced during surgery. In this case, we recognized that skin sclerosis in the neck and chest could lead to CICV. It may be suitable for airway management of scleroderma-like patients to select conscious intubation with a bronchoscope as a first choice.

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  • The intraoperative motor-evoked potential when propofol was changed to remimazolam during general anesthesia: a case series.

    Shoto Yamada, Yukinori Akiyama, Shunsuke Tachibana, Kengo Hayamizu, Yusuke Kimura, Shuichi Hashimoto, Michiaki Yamakage, Nobuhiro Mikuni

    Journal of anesthesia   37 ( 1 )   154 - 159   2023.2

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    Remimazolam is a short-acting benzodiazepine that was approved for clinical use in 2020. We report three patients who underwent surgery for cerebral and spinal cord tumors, in whom transcranial electrical stimulation-motor-evoked potential (TES-MEP) was successfully monitored under general anesthesia with remimazolam. During total intravenous anesthesia with propofol at a target concentration of 2.7 - 3.5 µg/mL and 0.1 - 0.35 µg/kg/min of remifentanil, delayed awakening, bradycardia, and hypotension during propofol anesthesia were expected in all three cases. With patient safety as the top priority, we considered changing the anesthetic agent. Propofol was replaced with remimazolam at a loading dose of 12 mg/kg/h for a few seconds (case 3), followed by 1 mg/kg/h for maintenance (cases 1-3). TES-MEP was recorded during propofol and remimazolam administration in all three patients. Amplitudes of TES-MEP during anesthesia with propofol and remimazolam were 461.5 ± 150 µV and 590.5 ± 100.9 µV, 1542 ± 127 µV and 1698 ± 211 µV, and 581.5 ± 91.3 µV and 634 ± 82.7 µV sequentially from Case 1. Our findings suggest that intraoperative TES-MEP could be measured when anesthesia was managed with remimazolam at 1 mg/kg/h.

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  • Correction to: The intraoperative motor-evoked potential when propofol was changed to remimazolam during general anesthesia: a case series.

    Shoto Yamada, Yukinori Akiyama, Shunsuke Tachibana, Kengo Hayamizu, Yusuke Kimura, Shuichi Hashimoto, Michiaki Yamakage, Nobuhiro Mikuni

    Journal of anesthesia   37 ( 1 )   160 - 160   2023.2

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  • Effect of remimazolam on intraoperative neurophysiology monitoring of visual-evoked potential: a case series.

    Shoto Yamada, Kengo Hayamizu, Yukinori Akiyama, Yusuke Kimura, Shuichi Hashimoto, Nobuhiro Mikuni, Michiaki Yamakage

    Journal of anesthesia   2023.1

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    There are very few reports on the effects of benzodiazepines such as midazolam and diazepam on intraoperative visual-evoked potential (VEP), and there is no report on the effect of remimazolam at all. Five patients underwent neurosurgery using VEP monitoring for avoiding surgical injury to the optic nerve. In all cases, drug administration was based on actual body weight. General anesthesia was induced with propofol and remifentanil, and then maintained with propofol at target concentrations of 2.7-3.5 µg/ml for maintaining bispectral index (BIS) between 40 and 60. After resection of the tumor under stable VEP, we discontinued propofol immediately followed by infusion of remimazolam at 12 mg/kg/h for a few seconds, then reduced to 1 mg/kg/h. After a time, when blood levels of remimazolam appeared to be stable, VEP was monitored again and compared to controls. In all cases, we were able to confirm that there was reproducibility. Remimazolam may provide a comparable quality of anesthesia to that of existing drugs for VEP in neurosurgery.

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  • 持続硬膜外鎮痛が困難な開胸胸壁再建手術に対し,モルヒネ硬膜外単回投与を含む多角的鎮痛で術後痛を管理した2症例

    新田 麻子, 立花 俊祐, 茶木 友浩, 山蔭 道明

    日本臨床麻酔学会誌   43 ( 1 )   25 - 30   2023.1

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  • Apnea management during WATCHMAN device deployment with apneic oxygenation: A case report of three cases. International journal

    Makishi Maeda, Yusuke Yoshikawa, Shunsuke Oura, Kanako Takahashi, Sho Ohno, Naoyuki Hirata, Michiaki Yamakage

    Annals of cardiac anaesthesia   26 ( 4 )   458 - 460   2023

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    WATCHMAN is a percutaneous left atrial appendage closure device that is implanted in patients who are unsuitable for anticoagulation therapy for atrial fibrillation. During WATCHMAN implantation, inducing apnea in the patient is preferable to allow stable deployment. We present three cases in which apneic oxygenation was employed to maintain oxygenation during apnea, and oxygen reserve index (ORiTM) was measured to evaluate its safety and efficacy. Oxygen was administered continuously via the endotracheal tube during apnea. During all four apneic events in three patients (mean duration of 356 seconds), the ORi values maintained above 0.24, which is generally considered the threshold of partial pressure of arterial oxygen (PaO2) > 100 mmHg. Transcutaneous oxygen saturation and PaO2 remained above 99% and 300 mmHg, respectively. There were no respiratory or circulatory complications during or after the surgery.

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  • Anesthetic management of tracheal stent extraction using a double gum elastic bougie technique

    Satoshi Sato, Tomohiro Chaki, Takayuki Onaka, Michiaki Yamakage

    JA Clinical Reports   8 ( 1 )   2022.12

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    Abstract

    Background

    Tracheal stenosis is a life-threatening condition, and management of a patient with a risk of tracheal stenosis is challenging for anesthesiologists. In this report, we describe a method for airway management using two gum elastic bougie method when removing a tracheal stent via a tracheostomy orifice with a risk of airway restenosis.

    Case presentation

    A 71-year-old man had an enlarged squamous cell carcinoma of the lung invading the upper mediastinum that had caused severe stenosis of the trachea. Two months after diagnosis, a tracheal stent had been placed to maintain tracheal patency. One month after stent placement, acute respiratory failure was induced by upper airway obstruction caused by subglottic airway edema due to mechanical stimulation of the cranial end of the stent, and the patient was rescued by oral tracheal intubation. Tracheal stent extraction was scheduled to relieve the laryngeal edema. Since there was a risk of tracheal restenosis because of the possibility of accidental evulsion of the orally tracheal tube which intubated to secure an emergency airway and tracheal stent extraction, two gum elastic bougies were inserted through the oral tracheal tube and tracheostomy orifice to facilitate re-intubation. After extraction of the tracheal stent, airway openness was maintained and tracheostomy was completed without any complication.

    Conclusion

    Successful management of tracheal stent extraction was performed using a double gum elastic bougie technique.

    Other Link: https://link.springer.com/article/10.1186/s40981-022-00500-z/fulltext.html

    DOI: 10.1186/s40981-022-00500-z

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  • 術前診察では予期できなかった気道確保困難に対してMcGRATH MAC併用の気管支ファイバースコープガイド下挿管が有用であった1症例

    小北 篤史, 立花 俊祐, 茶木 友浩, 枝長 充隆, 山蔭 道明

    麻酔   71 ( 11 )   1196 - 1200   2022.11

  • レミマゾラムによる全身麻酔導入が血行動態パラメータに与える影響 プロポフォールとの比較

    大浦 峻介, 吉川 裕介, 平田 直之, 枝長 充隆, 山蔭 道明

    Cardiovascular Anesthesia   26 ( Suppl. )   165 - 165   2022.9

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  • 六君子湯による心臓虚血再灌流傷害への新規治療戦略の可能性

    澤下 泰明, 佐藤 智恵, 平田 直之, 山蔭 道明

    Cardiovascular Anesthesia   26 ( Suppl. )   121 - 121   2022.9

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  • 経皮的左心耳閉鎖術のWATCHMANデバイス留置時に、Oxygen Reserve Indexを指標に安全な呼吸停止を行った2例

    大浦 峻介, 前田 真岐志, 大野 翔, 吉川 裕介, 平田 直之, 山蔭 道明

    Cardiovascular Anesthesia   26 ( Suppl. )   144 - 144   2022.9

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  • 加湿高流量経鼻カヌラを用いた意識下挿管においてOxygen Reserve Indexが有用であった甲状腺腫瘍症例

    高橋 友紀子, 平田 直之, 茶木 友浩, 山蔭 道明

    臨床モニター   33 ( Suppl. )   135 - 135   2022.6

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  • 術後嘔気嘔吐予防にオンダンセトロンを使用した硬膜下電極留置およびてんかん焦点切除術の麻酔管理

    田中 郁実, 茶木 友浩, 立花 俊祐, 山蔭 道明

    日本神経麻酔集中治療学会プログラム・抄録集   26回   42 - 42   2022.5

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  • Risk factors of cardiac arrest and failure to achieve return of spontaneous circulation during anesthesia: a 20-year retrospective observational study from a tertiary care university hospital.

    Makishi Maeda, Naoyuki Hirata, Tomohiro Chaki, Michiaki Yamakage

    Journal of anesthesia   36 ( 2 )   221 - 229   2022.4

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    PURPOSE: There is still a lack of robust data on the epidemiology of cardiac arrest during anesthesia. We investigated the frequency and risk factors of cardiac arrest during anesthesia over the past two decades at a tertiary care university hospital in Japan. METHODS: We retrospectively analyzed 111,851 anesthesia records of patients who underwent surgery under anesthesia between 2000 and 2019. Cardiac arrest cases were classified according to the patient's background, surgical status, main cause and initial rhythm of cardiac arrest, and the presence of the return of spontaneous circulation (ROSC). Univariate and multivariate logistic regression analyses were used to identify the risk factors of cardiac arrest and failure to achieve ROSC. RESULTS: Ninety cardiac arrest cases during anesthesia were identified. The incidence of cardiac arrest was 8.05 per 10,000 anesthetics (95% CI, 6.54-9.90). There were 6 anesthesia-related cardiac arrests and 9 anesthesia-contributory cardiac arrests. The most common cause of cardiac arrest was blood loss. American Society of Anesthesiologists physical status 4-5, emergency surgery, and cardiovascular surgery were identified as independent risk factors of cardiac arrest. American Society of Anesthesiologists physical status 4-5, blood loss-induced cardiac arrest, and non-shockable rhythm were independently associated with failure to achieve ROSC. CONCLUSION: Blood loss was the most common cause of cardiac arrest and blood loss-induced cardiac arrest was independently associated with failure to achieve ROSC. Further improvements in treatment strategies for bleeding may reduce the future incidence of cardiac arrest and death during anesthesia.

    DOI: 10.1007/s00540-021-03034-3

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  • Differential effects of remimazolam and propofol on heart rate variability during anesthesia induction.

    Gen Hasegawa, Naoyuki Hirata, Yusuke Yoshikawa, Michiaki Yamakage

    Journal of anesthesia   36 ( 2 )   239 - 245   2022.4

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    PURPOSE: The effects of remimazolam on autonomic nervous activity have not been elucidated. We investigated the differential effects of remimazolam and propofol on autonomic nervous activity during anesthesia induction. METHODS: Thirty patients were randomly divided into a remimazolam group or a propofol group for anesthesia induction. Hemodynamics and indices of heart rate variability were recorded before and after anesthesia. Low frequency power (LF; 0.04-0.15 Hz, ms2) and high frequency power (HF; 0.15-0.4 Hz, ms2) were calculated from power spectral density of heart rate variability. LF reflects both sympathetic and parasympathetic activities and HF reflects parasympathetic activity. To investigate the balance between sympathetic and parasympathetic activities, the normalized unit (%) of LF (LF nu) and that of HF (HF nu) were calculated. Changes in LF nu (ΔLF nu) before and after anesthesia (ΔLF nu = LF nu at awake-LF nu after anesthesia) were compared between the groups. RESULTS: Remimazolam and propofol decreased blood pressure and power spectral density of heart rate variability. Remimazolam did not change LF nu and HF nu, while propofol increased LF nu and decreased HF nu (P = 0.020). ΔLF nu in the remimazolam group (1.4 ± 23.6%) were less than that in the propofol group (19.3 ± 22.4%, P = 0.0415). CONCLUSION: Remimazolam and propofol decreased autonomic nervous activity during anesthesia induction. Remimazolam preserved the balance of sympathetic and parasympathetic activities, while propofol modulated it to sympathetic dominance.

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  • A case of monosomy 21 presented with difficult tracheal intubation. International journal

    Yoshiki Saito, Tomohiro Chaki, Noriaki Nishihara, Michiaki Yamakage

    JA clinical reports   8 ( 1 )   24 - 24   2022.3

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    BACKGROUND: Monosomy 21 is a rare chromosomal abnormality. It is mainly associated with mental retardation, intellectual disability, growth retardation, microcephaly, and characteristic facial features. General anesthesia in adults with this disease has not been reported. We report difficult airway management of an adult patient with monosomy 21. CASE DESCRIPTION: A 30-year-old female was scheduled for laparoscopic gynecological surgery. She was diagnosed with monosomy 21 at birth and accompanied with mental retardation. Preoperative examination revealed limited mouth opening with Mallampati score of IV, but no abnormal laboratory test or chest X-P. Anesthesia was performed using general anesthesia with epidural analgesia. Although bag-mask ventilation was improved by a muscle relaxant, mouth opening was further restricted, and laryngoscope insertion was impossible. Tracheal intubation was achieved using a bronchofiberscope. The operation procedure was completed, and the patient was discharged from the hospital without any major postoperative complications. CONCLUSIONS: In this patient, mouth opening was further reduced after induction of general anesthesia with a muscle relaxant. Preoperative evaluation and adequate preparation of airway management are important for general anesthesia in an adult patient with monosomy 21.

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  • Investigations into the efficacy of a novel extubation-aerosol shield: a cough model study. International journal

    Gen Hasegawa, Wataru Sakai, Tomohiro Chaki, Shunsuke Tachibana, Atsushi Kokita, Takenori Kato, Hidekazu Nishimura, Michiaki Yamakage

    Infection prevention in practice   4 ( 1 )   100193 - 100193   2022.3

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    Background: Physicians have had to perform numerous extubation procedures during the prolonged coronavirus disease 2019 (COVID 19) pandemic. Future pandemics caused by unknown pathogen may also present a risk of exposure to infectious droplets and aerosols. Aim: This study evaluated the ability of a newly developed aerosol barrier, "Extubation-Aerosol (EA)-Shield" to provide maximum protection from aerosol exposure during extubation via an aerosolised particle count and high-quality visualisation assessments. Methods: We employed a cough model having parameters similar to humans and used micron oil aerosol as well as titanium dioxide as aerosol tracers. Aerosol barrier techniques employing a face mask (group M) and EA-Shield (group H) were compared. Findings: The primary outcome was the difference in the number of particles contacting the physician's face before and after extubation. The maximum distances of aerosol dispersal after extubation were measured as the secondary outcomes. All aerosolised particles of the two tracers were significantly smaller in group H than in group M (p < 0.05). In addition, the sagittal and axial maximum distances and sagittal areas of aerosol dispersal for 3, 5, and 10 s after extubation were significantly smaller in group H than in group M (p < 0.05). Conclusion: This model indicates that EA-Shield could be highly effective in reducing aerosol exposure during extubation. Therefore, we recommend using it as an aerosol barrier when an infectious aerosol risk is suspected.

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  • 新規ベンゾジアゼピン系薬レミマゾラム及びその代謝物の血漿中濃度同時測定法

    村岡 愛, 市川 凌史, 青山 剛, 佐藤 慧, 茶木 友浩, 立花 俊祐, 山蔭 道明, 戸田 貴大

    日本薬学会年会要旨集   142年会   26PO4 - 01S   2022.3

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  • The Efficacy and Safety of Dexmedetomidine for Sedation During Surgery Under Epidural or Spinal Anesthesia: A Randomized, Double-Blind, Placebo-Controlled Study.

    Yoshimi Inagaki, Michiaki Yamakage, Atsuhiro Sakamoto, Akifumi Okayama, Nobuyo Oya, Takehiko Hiraoka, Kiyoshi Morita

    Yonago acta medica   65 ( 1 )   14 - 25   2022.2

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    Background: Only a few studies have been reported on the use of dexmedetomidine for sedating surgical patients requiring epidural or spinal anesthesia. We conducted a randomized, double-blind, placebo-controlled, parallel-group study at 12 hospitals in Japan. Methods: Adult patients were randomly allocated to receive an intravenous administration of placebo or dexmedetomidine at 0.067, 0.25, 0.5 or 1.0 µg/kg over 10 min after epidural or spinal anesthesia. All dexmedetomidine groups received dexmedetomidine 0.2-0.7 µg/kg/h to maintain an Observer's Assessment of Alertness/Sedation Scale (OAA/S) score of ≤ 4; however, propofol was administered to rescue patients who exceeded this score. Surgery was then started 15 min after study drug infusion in patients with OAA/S score of ≤ 4. The primary endpoint was the percentage of patients not requiring rescue propofol to achieve and maintain an OAA/S score of ≤ 4. Results: Of the 120 enrolled and randomized patients, 119 were treated the study: 22 received placebo and 97 received dexmedetomidine (23-25 patients per dose). Significantly more patients did not require propofol in the dexmedetomidine 0.5 and 1.0 µg/kg groups (68.0% and 80.0%, respectively) compared to the placebo group (22.7%) (P = 0.003 and P < 0.001, respectively). Common adverse events (AEs) were protocol-defined respiratory depression, bradycardia and hypotension. There was no significant difference in the incidence of AEs between the dexmedetomidine and the placebo groups. Conclusion: We concluded that loading doses of 0.5 and 1.0 µg/kg dexmedetomidine, followed by an infusion at a rate of 0.2-0.7 µg/kg/h, provide effective and well-tolerated sedation for surgical patients during epidural or spinal anesthesia. Clinical trials.gov identifier: NCT01438957.

    DOI: 10.33160/yam.2022.02.002

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  • A two-handed airway maneuver of mandibular advancement and mouth opening in the neutral neck position for immobilization of the cervical spine

    Atsushi Sawada, Gen Ochiai, Michiaki Yamakage

    Journal of Anesthesia   35 ( 6 )   811 - 817   2021.12

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    DOI: 10.1007/s00540-021-02981-1

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  • Author Correction: Validation of the relationship between coagulopathy and localization of hydroxyethyl starch on the vascular endothelium in a rat hemodilution model (Scientific Reports, (2021), 11, 1, (10694), 10.1038/s41598-021-89889-8)

    Ryu Azumaguchi, Yasuyuki Tokinaga, Satoshi Kazuma, Motonobu Kimizuka, Kosuke Hamada, Tomoe Sato, Michiaki Yamakage

    Scientific Reports   11 ( 1 )   2021.12

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    DOI: 10.1038/s41598-021-97486-y

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  • Validation of the relationship between coagulopathy and localization of hydroxyethyl starch on the vascular endothelium in a rat hemodilution model

    Ryu Azumaguchi, Yasuyuki Tokinaga, Satoshi Kazuma, Motonobu Kimizuka, Kosuke Hamada, Tomoe Sato, Michiaki Yamakage

    Scientific Reports   11 ( 1 )   2021.12

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  • Aerosol boxes decrease aerosol exposure only in depressurized rooms during aerosol-generating procedures in a simulation study.

    Wataru Sakai, Gen Hasegawa, Tomohiro Chaki, Shunsuke Tachibana, Michiaki Yamakage

    Journal of anesthesia   36 ( 5 )   623 - 632   2021.9

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    PURPOSE: The aim of this study was to compare aerosol exposure with or without an aerosol box in a pressurized/depressurized room during aerosol-generating procedures using an experimental model. METHODS: Cake flour (aerosol model) was expelled from an advanced life support training mannequin. The primary outcome measure was the number of 0.3-10 µm-sized particles at three locations corresponding to the physician, medical staff, and environmental aerosol exposure levels. The aerosol dispersion was visualized using a high-resolution video. The number of expelled particles was measured after artificial coughing during simulated tracheal intubation and extubation in four situations, with or without an aerosol box in a pressurized or depressurized room (≤ 2.5 Pa). RESULTS: The particles arising from tracheal intubation at the three positions in the four groups differed significantly in size (p < 0.05). The sizes of particles arising from extubation at the physicians' and medical staff's faces in the four groups differed significantly in size (p < 0.05). Post hoc analysis showed that the counts of all particles at the three positions were significantly lower in the depressurized room with an aerosol box than in the pressurized room without an aerosol box during tracheal intubation (p < 0.05 at three positions) and extubation (p < 0.05) at the physician's and medical staff's positions). Visual assessments supported these results. CONCLUSION: The aerosol box decreased the exposure of the aerosol to the physician, medical staff, and environment during aerosol-generating procedures in the depressurized room only.

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  • 虚血再灌流障害によるグリコカリックスの障害に対するアルブミンの保護作用の検討

    数馬 聡, 澤下 泰明, 菊池 謙一郎, 巽 博臣, 黒田 浩光, 相坂 和貴子, 後藤 祐也, 寺田 拡文, 山蔭 道明, 升田 好樹

    日本集中治療医学会雑誌   28 ( Suppl.2 )   336 - 336   2021.9

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  • 人工心肺使用心臓手術後の高乳酸血症は30日死亡のリスクとなる

    長谷川 源, 平田 直之, 山蔭 道明

    日本集中治療医学会雑誌   28 ( Suppl.2 )   361 - 361   2021.9

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  • Near-infrared spectroscopy monitoring during one-lung ventilation in idiopathic pulmonary fibrosis. International journal

    Yuma Sato, Mitsutaka Edanaga, Naoyuki Hirata, Michiaki Yamakage

    Anaesthesia and intensive care   49 ( 5 )   310057X211027894 - 413   2021.8

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  • 気管腕頭動脈瘻を塞栓したコイルが気管に迷入し、その摘出に難渋した1症例

    佐藤 優真, 新山 幸俊, 本間 舞子, 山蔭 道明

    麻酔   70 ( 8 )   836 - 839   2021.8

  • Effect of remimazolam on intraoperative neuromonitoring during thyroid surgery: a case series.

    Kengo Hayamizu, Tomohiro Chaki, Shunsuke Tachibana, Naoyuki Hirata, Michiaki Yamakage

    Journal of anesthesia   35 ( 4 )   581 - 585   2021.8

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    Intraoperative neuromonitoring is widely used to prevent accidental injury during thyroid surgery. Anesthesia should be performed without muscle relaxant or agents with high muscle-relaxant potency. Remimazolam, a novel intravenous anesthetic, became available for clinical use in 2020. Remimazolam is an ultra-short-acting benzodiazepine with a very high clearance rate. However, there are very few data regarding its effect on currently used intraoperative neurological monitoring. Five patients underwent thyroid surgery using intraoperative recurrent laryngeal neuromonitoring. In all cases, intubation was performed after the administration of rocuronium. Anesthesia was maintained by continuous administration of remimazolam at the recommended dose and remifentanil, and no additional rocuronium or sugammadex was administered. Recurrent laryngeal nerve activity could be detected at the first stimulus after surgery was started, and monitoring continued thereafter. Intraoperative monitoring was performed without problems and all surgeries were completed without any complications. Anesthesia with remimazolam at the normal dose did not prolong the time to first positive electromyogram in patients undergoing thyroid surgery, and enables intraoperative recurrent laryngeal nerve monitoring to be performed without any serious perioperative adverse events. Remimazolam may provide a comparable quality of anesthesia to that of existing drugs for neuromonitoring during thyroid surgery.

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  • Unexpected tachycardia and hypertension during anesthetic induction with remimazolam in cardiac surgery: a case report. International journal

    Tomoe Sato, Sho Ohno, Makishi Maeda, Yasuaki Sawashita, Naoyuki Hirata, Michiaki Yamakage

    JA clinical reports   7 ( 1 )   58 - 58   2021.7

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  • Dexmedetomidine Ameliorates Perioperative Neurocognitive Disorders by Suppressing Monocyte-Derived Macrophages in Mice With Preexisting Traumatic Brain Injury. International journal

    Natsumi Kii, Atsushi Sawada, Yusuke Yoshikawa, Shunsuke Tachibana, Michiaki Yamakage

    Anesthesia and analgesia   134 ( 4 )   869 - 880   2021.7

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    BACKGROUND: Traumatic brain injury (TBI) initiates immune responses involving infiltration of monocyte-derived macrophages (MDMs) in the injured brain tissue. These MDMs play a key role in perioperative neurocognitive disorders (PNDs). We tested the hypothesis that preanesthetic treatment with dexmedetomidine (DEX) could suppress infiltration of MDMs into the hippocampus of TBI model mice, ameliorating PND. METHODS: We first performed bone marrow transplantation from green fluorescent protein-transgenic mice to C57BL/6 mice to identify MDMs. We used only male mice for homogeneity. Four weeks after transplantation, a controlled cortical impact model of TBI was created using recipient mice. Four weeks after TBI, mice received pretreatment with DEX before general anesthesia (GA). Mice performed the Barnes maze test (8-12 mice/group) 2 weeks after GA and were euthanized for immunohistochemistry (4-5 mice/group) or immunoblotting (7 mice/group) 4 weeks after GA. RESULTS: In Barnes maze tests, TBI model mice showed longer primary latency (mean difference, 76.5 [95% confidence interval, 41.4-111.6], P < .0001 versus Naïve), primary path length (431.2 [98.5-763.9], P = .001 versus Naïve), and more primary errors (5.7 [0.62-10.7], P = .017 versus Naïve) than Naïve mice on experimental day 3. Expression of MDMs in the hippocampus was significantly increased in TBI mice compared to Naïve mice (2.1 [0.6-3.7], P = .003 versus Naïve). Expression of monocyte chemotactic protein-1 (MCP1)-positive areas in the hippocampus was significantly increased in TBI mice compared to Naïve mice (0.38 [0.09-0.68], P = .007 versus Naïve). Immunoblotting indicated significantly increased expression of interleukin-1β in the hippocampus in TBI mice compared to Naïve mice (1.59 [0.08-3.1], P = .035 versus Naïve). In contrast, TBI mice pretreated with DEX were rescued from these changes and showed no significant difference from Naïve mice. Yohimbine, an α2 receptor antagonist, mitigated the effects of DEX (primary latency: 68.3 [36.5-100.1], P < .0001 versus TBI-DEX; primary path length: 414.9 [120.0-709.9], P = .0002 versus DEX; primary errors: 6.6 [2.1-11.2], P = .0005 versus TBI-DEX; expression of MDMs: 2.9 [1.4-4.4], P = .0001 versus TBI-DEX; expression of MCP1: 0.4 [0.05-0.67], P = .017 versus TBI-DEX; expression of interleukin-1β: 1.8 [0.34-3.35], P = .01 versus TBI-DEX). CONCLUSIONS: Preanesthetic treatment with DEX suppressed infiltration of MDMs in the hippocampus and ameliorated PND in TBI model mice. Preanesthetic treatment with DEX appears to suppress infiltration of MDMs in the hippocampus and may lead to new treatments for PND in patients with a history of TBI.

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  • Safety of an improved pediatric epidural tunneling technique for catheter shear. International journal

    Wataru Sakai, Shunsuke Tachibana, Tomohiro Chaki, Naofumi Nakazato, Yuri Horiguchi, Yuko Nawa, Michiaki Yamakage

    Paediatric anaesthesia   31 ( 7 )   770 - 777   2021.7

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    BACKGROUND: Epidural tunneling could help with prolonged catheterization and be effective in preventing infection and dislodgement. However, epidural tunneling techniques carry a risk of catheter shear or needlestick injuries. AIMS: This study aimed to examine the safety of our epidural tunneling technique in terms of catheter shear. METHODS: This study was designed as a double-blinded, single-crossover, in vitro study. Each of the operators performed two techniques to create a subcutaneous tunnel. We compared outcomes between the control tunneling technique (group C) and our improved technique (group I). Microscopic findings of catheter shear were assessed as the primary outcome. Secondary outcomes included the tension and displacement required to break the epidural catheter and the frequency of catheter breakage due to catheter shear. Data were analyzed using the Fisher's exact test and Mann-Whitney U test. A p-value of <.05 was considered statistically significant. RESULTS: Ten catheters were assessed in each group. The frequency of catheter shear was 10% in group I and 90% in group C (odds ratio, 0.019; 95% confidence interval [CI], 0.01-0.31; p < .001). The frequency of catheter breakage due to catheter shear was significantly lower in group I (0%) than in group C (80%; p < .001). The mean tension and displacement required to break the catheter were significantly higher in group I than in group C (4.13 ± 0.37 N vs. 3.14 ± 1.00 N; mean difference, 0.99 N; 95% CI, 0.25-1.73 N; p = .013 and 222 ± 59.9 mm vs. 122 ± 77.7 mm; mean difference, 100 mm; 95% CI, 34.1-165 mm; p = .005). CONCLUSIONS: Our improved epidural tunneling technique, which was designed for pediatric cases, could reduce the risk of catheter shear.

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  • Preoperative right ventricular dysfunction requires high vasoactive and inotropic support during off-pump coronary artery bypass grafting.

    Tatsuya Kunigo, Yusuke Yoshikawa, Shuji Yamamoto, Michiaki Yamakage

    General thoracic and cardiovascular surgery   69 ( 6 )   934 - 942   2021.6

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    OBJECTIVES: The association of preoperative RV function with hemodynamics during OPCAB or emergency conversion is not clear. The aim of this study was to investigate the association of vasoactive-inotropic score with tricuspid annular plane systolic excursion and tricuspid regurgitation in off-pump coronary artery bypass grafting, and to calculate the optimal cut-off value of tricuspid annular plane systolic excursion to predict emergency conversion to cardiopulmonary bypass. METHODS: Patients over 20 years of age who had undergone off-pump coronary artery bypass grafting between April 2015 and March 2020 were enrolled in this study. We retrospectively assessed the association of intraoperative maximum "vasoactive-inotropic score", a weighted sum of various inotropes and vasoconstrictors, with tricuspid annular plane systolic excursion and tricuspid regurgitation. A receiver operating characteristic curve of conversion on tricuspid annular plane systolic excursion was also constructed. RESULTS: 135 patients were included in final analysis. Conversion was performed in 10 cases. Multiple regression analysis showed that tricuspid annular plane systolic excursion, mild or more tricuspid regurgitation and experienced surgeon were significantly related to vasoactive-inotropic score. The receiver operating characteristic curve to predict conversion by tricuspid annular plane systolic excursion showed an optimal cut-off value of 15.0 mm and area under the curve of 0.808. CONCLUSIONS: Tricuspid annular plane systolic excursion and tricuspid regurgitation were associated with vasoactive-inotropic score in off-pump coronary artery bypass grafting. The optimal cut-off value of tricuspid annular plane systolic excursion to predict emergency conversion was 15 mm.

    DOI: 10.1007/s11748-020-01557-2

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  • Generic rocuronium reduces withdrawal movements compared to original rocuronium under target-controlled infusion induction with propofol

    Kosuke Hamada, Kazunobu Takahashi, Yasuyuki Tokinaga, Soshi Iwasaki, Michiaki Yamakage

    Journal of Anesthesia   35 ( 2 )   184 - 188   2021.4

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    DOI: 10.1007/s00540-020-02889-2

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  • Remimazolam use for awake craniotomy. International journal

    Shunsuke Tachibana, Kengo Hayamizu, Michiaki Yamakage

    JA clinical reports   7 ( 1 )   25 - 25   2021.3

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  • Remimazolam anesthesia for cardiac surgery with cardiopulmonary bypass: a case report. International journal

    Kota Saito, Sho Ohno, Makishi Maeda, Naoyuki Hirata, Michiaki Yamakage

    JA clinical reports   7 ( 1 )   21 - 21   2021.3

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    BACKGROUND: Remimazolam has less cardiovascular depressant effects than propofol in non-cardiac surgical patients. However, the efficacy and safety of remimazolam in cardiac surgery with cardiopulmonary bypass (CPB) have not been reported. We present a case of successful anesthetic management using remimazolam in cardiac surgery with CPB. CASE PRESENTATION: A 76-year-old female was scheduled for mitral valve repair, tricuspid annuloplasty, maze procedure, and left atrial appendage closure. We used remimazolam in induction (6.0 mg/kg/h) and maintenance (0.6-1.0 mg/kg/h) of general anesthesia, and the bispectral index value was maintained in the range of 36 to 48 including the period of CPB. Hemodynamics, mixed venous oxygen saturation, and bilateral regional cerebral oxygen saturation were maintained within acceptable ranges. There was no intraoperative awareness/recall or serious complications associated with remimazolam throughout the perioperative period. CONCLUSIONS: Remimazolam can be used the same as other existing anesthetics in cardiac surgery with CPB.

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  • Head Rotation Reduces Oropharyngeal Leak Pressure of the i-gel and LMA® Supreme™ in Paralyzed, Anesthetized Patients: A Randomized Trial. International journal

    Tomohiro Chaki, Shunsuke Tachibana, Sho Kumita, Honami Sato, Kosuke Hamada, Yasuyuki Tokinaga, Michiaki Yamakage

    Anesthesia and analgesia   132 ( 3 )   818 - 826   2021.3

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    BACKGROUND: Second-generation supraglottic airway (SGA) devices are useful for airway management during positive pressure ventilation in general anesthesia and emergency medicine. In some clinical settings, such as the anesthetic management of awake craniotomy, SGAs are used in the head-rotated position, which is required for exposure of the surgical field, although this position sometimes worsens the efficiency of mechanical ventilation with SGAs. In this study, we investigated and compared the influence of head rotation on oropharyngeal leak pressures (OPLP) of the i-gel and LMA® Supreme™, which are second-generation SGA devices. METHODS: Patients who underwent elective surgery under general anesthesia were enrolled in this study and randomly divided into i-gel or LMA Supreme groups. After induction of anesthesia with muscle relaxation, the i-gel or LMA Supreme was inserted according to computerized randomization. The primary outcome was the OPLP at 0°, 30°, and 60° head rotation. The secondary outcomes were the maximum airway pressure and expiratory tidal volume when patients were mechanically ventilated using a volume-controlled ventilation mode with a tidal volume of 10 mL/kg (ideal body weight), ventilation score, and fiber-optic views of vocal cords. RESULTS: Thirty-four and 36 participants were included in the i-gel and LMA Supreme groups, respectively. The OPLPs of the i-gel and LMA Supreme significantly decreased as the head rotation angle increased (mean difference [95% confidence interval], P value: i-gel; 0° vs 30°: 3.5 [2.2-4.8], P < .001; 30° vs 60°: 2.0 [0.6-3.5], P = .002; 0° vs 60°: 5.5 [3.3-7.8], P < .001, LMA Supreme; 0° vs 30°: 4.1 [2.6-5.5], P < .001; 30° vs 60°: 2.4 [1.1-3.7], P < .001; 0° vs 60°: 6.5 [5.1-8.0], P < .001). There were statistically significant differences in expiratory tidal volume and ventilation score between 0° and 60° in the i-gel group and in ventilation score between 30° and 60° in the LMA Supreme group. There was no statistically significant difference between the 2 devices in all outcome measures. The incidences of adverse events, such as hoarseness or sore throat, were not significantly different between i-gel and LMA Supreme. CONCLUSIONS: Head rotation to 30° and 60° reduces OPLP with both i-gel and LMA Supreme. There is no difference in OPLP between i-gel and LMA Supreme in the 3 head rotation positions.

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  • Comparison between oxygen reserve index and end-tidal oxygen concentration for estimation of oxygenation during pre-oxygenation via a tight-fitted face mask: A prospective observational study. International journal

    Naoyuki Hirata, Mitsuo Nishimura, Tomohiro Chaki, Yusuke Yoshikawa, Michiaki Yamakage

    European journal of anaesthesiology   38 ( 3 )   313 - 315   2021.3

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    DOI: 10.1097/EJA.0000000000001358

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  • Remimazolam for a patient with myotonic dystrophy type 1 who underwent endoscopic retrograde cholangiopancreatography under general anesthesia: a case report. International journal

    Masakazu Fukuda, Shunsuke Tachibana, Noriaki Nishihara, Michiaki Yamakage

    JA clinical reports   7 ( 1 )   17 - 17   2021.2

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    BACKGROUND: Remimazolam is a benzodiazepine receptor agonist with an ultra-short-acting anesthetic effect. We used remimazolam for anesthesia in a patient with myotonic dystrophy type 1 who underwent endoscopic retrograde cholangiopancreatography (ERCP). CASE PRESENTATION: A 58-year-old woman received ERCP under general anesthesia. She had impaired respiratory function due to myotonic dystrophy type I and was at a risk of respiratory complications after anesthesia. General anesthesia was induced with remimazolam 12 mg/kg/h, remifentanil 0.1 μg/kg/min and rocuronium 15 mg, followed by tracheal intubation and maintained with remimazolam 0.8-1.0 mg/kg/h. At the end of anesthesia, we injected sugammadex 150 mg and flumazenil 0.2 mg, allowing smooth and clear emergence from anesthesia. She was discharged from the hospital without any respiratory problems on postoperative day 5. CONCLUSIONS: Remimazolam was safe to use for general anesthesia in a patient with myotonic dystrophy type 1 undergoing ERCP.

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  • Effects of anesthetic agents on contractions of the pregnant rat myometrium in vivo and in vitro

    Motonobu Kimizuka, Yasuyuki Tokinaga, Ryu Azumaguchi, Kosuke Hamada, Satoshi Kazuma, Michiaki Yamakage

    Journal of Anesthesia   35 ( 1 )   68 - 80   2021.2

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    DOI: 10.1007/s00540-020-02866-9

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  • Erector spinae plane block versus retrolaminar block for postoperative analgesia after breast surgery: a randomized controlled trial.

    Sayaka Sotome, Atsushi Sawada, Asaka Wada, Hiroaki Shima, Goro Kutomi, Michiaki Yamakage

    Journal of anesthesia   35 ( 1 )   27 - 34   2021.2

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    PURPOSE: The newly introduced erector spinae plane block (ESPB) has given anesthesiologists an alternative regional anesthetic technique for thoracic analgesia. Although ESPB and retrolaminar block (RLB) have similar puncture sites, no clinical study comparing ESPB and RLB has been reported. The aim of this study was to compare ESPB and RLB in terms of analgesic efficacy in the context of multimodal analgesia following breast surgery. METHODS: Fifty female patients undergoing breast surgery under general anesthesia were randomly allocated to receive either ultrasound-guided ESPB or RLB with 20 mL of 0.375% levobupivacaine for postoperative analgesia. The primary outcome was analgesic efficacy in terms of time to first postoperative rescue analgesic after the block procedure. The secondary outcomes were consumption of remifentanil during anesthesia, pain intensity at rest for 24 h postoperatively, and occurrence of postoperative nausea and vomiting (PONV). RESULTS: After excluding five patients, 45 patients (22 and 23 patients in the ESPB and RLB group, respectively) were analyzed. Median time until the first postoperative rescue analgesic after the block procedure in the ESPB group was not significantly longer than that in the RLB group (8.6 [range 2.7-24] vs. 4.8 [3.0-24] h; P = 0.83). There was no significant difference in the consumption of remifentanil during anesthesia, pain intensity at rest for 24 h postoperatively, and occurrence of PONV between the two groups. CONCLUSION: ESPB is equivalent, and not superior, to RLB for postoperative analgesia after breast surgery when 20 mL of 0.375% levobupivacaine is injected at the fourth thoracic vertebra.

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  • Reply to the letter.

    Naoyuki Hirata, Michiaki Yamakage

    Journal of anesthesia   35 ( 1 )   162 - 162   2021.2

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  • Careful medical interview and ultrasonography enabled detection of acute kidney injury and hematoma after lumbar trigger point injection-a case report. International journal

    Satoshi Sato, Shunsuke Tachibana, Kayoko Okazaki, Hitoshi Namba, Takahiro Ichimiya, Michiaki Yamakage

    JA clinical reports   7 ( 1 )   12 - 12   2021.1

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    BACKGROUND: Trigger point blocks are now widely practiced, especially in pain treatment. Among the complications of lumbar trigger point injection, reports of medically induced kidney injury are very rare, and diagnosis during emergency treatment is rare. CASE PRESENTATION: A 78-year-old woman on antiplatelet medication following a stroke was diagnosed with treatable type A aortic dissection at another hospital after undergoing lumbar trigger point injection. On arrival at our hospital, there were no signs of hemodynamic deterioration. Additional careful medical re-interview and ultrasonography by anesthesiologists enabled a definitive diagnosis of acute kidney damage and hematoma caused by lumbar trigger point injection, and aortic dissection surgery was abandoned. CONCLUSION: This clinical case demonstrates the importance of awareness of potential kidney injury and hematoma during lumbar trigger point injection.

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  • Subcutaneous tunnelling of pediatric peripheral nerve block catheters: a novel technique to minimize catheter damage. International journal

    Wataru Sakai, Tomohiro Chaki, Shunsuke Tachibana, Yuko Nawa, Michiaki Yamakage

    Canadian journal of anaesthesia = Journal canadien d'anesthesie   68 ( 1 )   159 - 160   2021.1

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  • レミマゾラム 薬理学的特徴と臨床での使用法

    平田 直之, 柴田 賢吾, 大中 崇行, 立花 俊祐, 澤田 敦史, 山蔭 道明

    臨床麻酔   45 ( 1 )   9 - 15   2021.1

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  • Injectate spread in ultrasound-guided inferior alveolar nerve block: a cadaveric study

    Sho Kumita, Atsushi Sawada, Taka-aki Tokura, Koyo Nishiyama, Daisuke Oiwa, Hironari Dehari, Akihiro Miyazaki, Mineko Fujimiya, Michiaki Yamakage

    Journal of Anesthesia   2021

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  • Remimazolam Anesthesia for MitraClip Implantation in a Patient with Advanced Heart Failure. International journal

    Tomoe Satoh, Noriaki Nishihara, Yasuaki Sawashita, Sho Ohno, Naoyuki Hirata, Michiaki Yamakage

    Case reports in anesthesiology   2021   5536442 - 5536442   2021

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    Remimazolam, a novel and ultrashort-acting benzodiazepine, has been available for general anesthesia in Japan. The administration of remimazolam does not induce injection pain, has been reported to have less cardiovascular depressant effects during general anesthesia, and flumazenil can antagonize the effects of remimazolam. However, in clinical trials, no patient who is complicated with severe heart failure or undergoes cardiac surgery was included. We present anesthetic management with remimazolam for MitraClip® implantation in a patient with severe mitral regurgitation and advanced heart failure. Remimazolam was administered both in anesthetic induction and maintenance with less cardiovascular depressant effects. After surgical procedures were completed, the patient smoothly recovered from anesthesia and the tracheal was extubated just after administration of flumazenil. Remimazolam may be able to achieve appropriate anesthetic management in patients complicated with severe cardiovascular diseases.

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  • Acute Hypobaric and Hypoxic Preconditioning Reduces Myocardial Ischemia-Reperfusion Injury in Rats. International journal

    Hirofumi Terada, Naoyuki Hirata, Yasuaki Sawashita, Sho Ohno, Yusuke Yoshikawa, Michiaki Yamakage

    Cardiology research and practice   2021   6617374 - 6617374   2021

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    Background: Chronic and/or intermittent exposure to hypobaric hypoxia reportedly exerts cardioprotective effects against ischemia-reperfusion injury. However, few studies have focused on the cardioprotective effects of acute and/or short-term hypobaric and hypoxic exposures. This study investigated the effects of acute hypobaric hypoxia on myocardial ischemia-reperfusion injury. Materials and Methods: Rats were assigned to groups receiving normobaric normoxia (NN group), hypobaric hypoxia (HH group), or normobaric hypoxia (NH group). HH group rats were exposed to 60.8 kPa and 12.6% fraction of inspired oxygen in a hypobaric chamber for 6 h. NH group rats were exposed to hypoxic conditions under normal pressure. After each exposure, 30 min of myocardial ischemia was followed by 60 min of reperfusion. Cardiac function and infarct size were determined after reperfusion. Expression of hypoxia-inducible factor 1 alpha (HIF1α) was also measured. Results: Cardiac function was better preserved in the HH and NH groups than in the NN group (p < 0.01 each). Median infarct size/area at risk was significantly lower in the HH group (50%, interquartile range [IQR] 48-54%; p < 0.01 vs. NN group) and NH group (45%, IQR 36-50%; p < 0.01 vs. NN group) than in the NN group (72%, IQR 69-75%). HIF1α expression was significantly higher in the HH group (p < 0.05 vs. NN group) and NH group (p < 0.01 vs. NN group) than in the NN group. Conclusions: Exposure to acute and/or short-term hypobaric and hypoxic conditions might exert cardioprotective effects against myocardial ischemia-reperfusion injury via HIF1α modulation.

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  • How to administer remimazolam for anesthesia induction.

    Naoyuki Hirata, Kengo Hayamizu, Michiaki Yamakage

    Journal of anesthesia   34 ( 6 )   962 - 962   2020.12

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  • 麻酔導入後に誘因なく高カリウム血症と代謝性アシドーシスを認めた症例

    長門 真美, 平田 直之, 新山 幸俊, 山蔭 道明

    臨床モニター   31 ( Suppl. )   98 - 98   2020.11

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  • A patient with myotonic dystrophy diagnosed after experiencing sudden respiratory failure: a case report. International journal

    Noriaki Nishihara, Shunsuke Tachibana, Hajime Sonoda, Michiaki Yamakage

    JA clinical reports   6 ( 1 )   80 - 80   2020.10

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    BACKGROUND: Myotonic dystrophy is a disorder affecting multiple organs including skeletal muscles and causes respiratory failure. We describe a patient who developed respiratory failure, with delayed diagnosis of myotonic dystrophy type 1 as the cause. CASE PRESENTATION: A 62-year-old woman developed acute onset of dyspnea after showing hypertension and tachycardia and was transported to our hospital. On arrival at our institution, SpO2 was 80% with a non-rebreather mask. With a diagnosis of acute phase heart failure, she underwent tracheal intubation. However, weaning from the respirator was difficult in the intensive care unit (ICU). A detailed interview revealed that her brother was affected with myotonic dystrophy type 1. She was also diagnosed with myotonic dystrophy type 1 by a genetic test. CONCLUSIONS: Taking a careful past and family history and prompt genetic testing is required on suspicion of neuromuscular diseases in a patient with respiratory failure by an unknown cause.

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  • Tracheal extubation of anesthetized pediatric patients with heart disease decreases the incidence of emergence agitation: A retrospective study

    Tatsuya Kunigo, Yuko Nawa, Yusuke Yoshikawa, Michiaki Yamakage

    Annals of Cardiac Anaesthesia   23 ( 4 )   433 - 438   2020.10

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Wolters Kluwer Medknow Publications  

    DOI: 10.4103/aca.ACA_69_19

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  • Cross-Holes on a Plastic Bag Can Prevent Droplet Spread During Extubation. International journal

    Wataru Sakai, Shunsuke Tachibana, Michiaki Yamakage

    Anesthesia and analgesia   131 ( 4 )   e189-e191   2020.10

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    DOI: 10.1213/ANE.0000000000005090

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  • 気管挿管後に遅発性気管支閉塞を生じた上行弓部大動脈瘤症例の麻酔経験

    五月女 風香, 茶木 友浩, 平田 直之, 山蔭 道明

    麻酔   69 ( 10 )   1060 - 1063   2020.10

  • Assessing the validity of a linear inflation method in noninvasive blood pressure monitoring during the induction period of general anaesthesia. International journal

    Ken-Ichiro Kikuchi, Naoyuki Hirata, Yusuke Yoshikawa, Michiaki Yamakage

    Journal of perioperative practice   31 ( 12 )   1750458920957917 - 1750458920957917   2020.9

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    Inflationary noninvasive blood pressure (iNIBP) monitoring can determine BP in a shorter time compared to conventional deflationary NIBP (dNIBP) monitoring. We assessed the efficacy of iNIBP monitoring during induction of general anaesthesia and tracheal intubation, which can cause rapid changes in haemodynamics. Our study included 14 surgery patients receiving tracheal intubation under general anaesthesia. Blood pressure was continuously measured using iNIBP monitoring. We recorded the percentage of successful iNIBP monitoring (measurements made without switching to dNIBP mode) during anaesthesia induction. We obtained 326 BP-measurements from 14 patients. The iNIPB mode was able to perform 90.9% of the measurements during the induction of general anaesthesia. iNIBP could determine BP even during periods of high blood pressure variability (31.6% [interquartile range; 22-40]). Our results validate the utility of iNIBP monitoring during the induction period of general anaesthesia, despite the rapid haemodynamic changes.

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  • Cerebrospinal fluid drainage to prevent postoperative spinal cord injury in thoracic aortic repair. Reviewed

    Kenji Yoshitani, Masahiko Kawaguchi, Mikito Kawamata, Manabu Kakinohana, Shinya Kato, Kyoko Hasuwa, Michiaki Yamakage, Yusuke Yoshikawa, Kimitoshi Nishiwaki, Kazuko Hasegawa, Yoshimi Inagaki, Kazumi Funaki, Mishiya Matsumoto, Kazuyoshi Ishida, Atsuo Yamashita, Katsuhiro Seo, Shinichi Kakumoto, Kosuke Tsubaki, Satoshi Tanaka, Takashi Ishida, Hiroyuki Uchino, Takayasu Kakinuma, Yoshitsugu Yamada, Yoshiteru Mori, Shunsuke Izumi, Jun Shimizu, Yuko Furuichi, Nobuhide Kin, Shoichi Uezono, Kotaro Kida, Kunihiko Nishimura, Michikazu Nakai, Yoshihiko Ohnishi

    Journal of anesthesia   35 ( 1 )   43 - 50   2020.9

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

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  • Cardiovascular considerations for anesthesiologists during the COVID-19 pandemic.

    Naoyuki Hirata, Michiaki Yamakage

    Journal of anesthesia   35 ( 3 )   361 - 365   2020.9

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    The coronavirus disease (COVID-19) pandemic has brought critical challenges to anesthesiologists and perioperative practice. Whereas anesthesiologists may be primarily concerned with airway and respiratory management, the COVID-19 data accumulated to date indicate that primary and/or secondary cardiovascular complications are common. Previous studies have demonstrated that the mortality rate is significantly higher in patients with cardiovascular disease (CVD) than in patients without CVD. Dysregulation of immune function in patients with CVD may be involved in the prognosis of COVID-19 patients. Anesthesia and surgical procedures can modulate the immune system, and some patients undergoing surgery, particularly those undergoing cardiovascular procedures, have CVD. In perioperative management for patients with suspected or diagnosed COVID-19 and those who have recovered from COVID-19, it is important for anesthesiologists to be concerned not only with airway and respiratory management, but also with cardiovascular complications and perioperative circulatory management to control the progression of the disease in patients with COVID-19.

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  • Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb/III trial. Reviewed

    Matsuyuki Doi, Kiyoshi Morita, Junzo Takeda, Atsuhiro Sakamoto, Michiaki Yamakage, Toshiyasu Suzuki

    Journal of anesthesia   34 ( 4 )   543 - 553   2020.8

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    PURPOSE: This trial was conducted to confirm the non-inferiority of remimazolam versus propofol in the induction and maintenance of general anesthesia in surgical patients. METHODS: Surgical patients (n = 375) were randomized to remimazolam started at 6 or 12 mg/kg/h by continuous intravenous (IV) infusion until the loss of consciousness (LoC), followed by 1 mg/kg/h to be adjusted as appropriate until the end of surgery or IV propofol administered as a slow bolus of 2.0-2.5 mg/kg until LoC followed by 4-10 mg/kg/h until the end of surgery. Efficacy was measured via the combined primary endpoint of no intraoperative awakening/recall, no need for rescue sedatives, and no body movements. Adverse events and adverse drug reactions (ADRs) were monitored for safety. RESULTS: Efficacy rates were 100% in all treatment groups, and the non-inferiority of remimazolam was demonstrated [95% confidence interval (- 0.0487; 0.0250)]. The time to LoC was longer in the remimazolam 6 (p < 0.0001) and 12 mg/kg/h (p = 0.0149) groups versus propofol. The time to extubation was longer in both remimazolam groups versus the propofol group (p ≤ 0.0001). The incidence of ADRs was similar in the remimazolam groups (39.3% and 42.7%, respectively) compared with the propofol group (61.3%). Decreased blood pressure occurred in 20.0% and 24.0% of patients treated with 6 and 12 mg/kg/h remimazolam, respectively, compared with 49.3% of patients receiving propofol. Injection site pain was reported in 18.7% of propofol patients but not in those receiving remimazolam. CONCLUSIONS: This trial demonstrated that remimazolam was well tolerated and non-inferior to propofol with regard to efficacy as a sedative hypnotics for general anesthesia. CLINICAL TRIAL REGISTRATION: This trial is registered with the Japan Pharmaceutical Information Center - Clinical Trials Information (JapicCTI). JapicCTI number: 121973.

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  • Remote ischemic preconditioning reduces myocardial ischemia-reperfusion injury through unacylated ghrelin-induced activation of the JAK/STAT pathway. International journal

    Yasuaki Sawashita, Naoyuki Hirata, Yusuke Yoshikawa, Hirofumi Terada, Yasuyuki Tokinaga, Michiaki Yamakage

    Basic research in cardiology   115 ( 4 )   50 - 50   2020.6

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    Remote ischemic preconditioning (RIPC) offers cardioprotection against myocardial ischemia-reperfusion injury. The humoral factors involved in RIPC that are released from parasympathetically innervated organs have not been identified. Previous studies showed that ghrelin, a hormone released from the stomach, is associated with cardioprotection. However, it is unknown whether or not ghrelin is involved in the mechanism of RIPC. This study aimed to determine whether ghrelin serves as one of the humoral factors in RIPC. RIPC group rats were subjected to three cycles of ischemia and reperfusion for 5 min in two limbs before left anterior descending (LAD) coronary artery ligation. Unacylated ghrelin (UAG) group rats were given 0.5 mcg/kg UAG intravenously 30 min before LAD ligation. Plasma levels of UAG in all groups were measured before and after RIPC procedures and UAG administration. Additionally, JAK2/STAT3 pathway inhibitor (AG490) was injected in RIPC and UAG groups to investigate abolishment of the cardioprotection of RIPC and UAG. Plasma levels of UAG, infarct size and phosphorylation of STAT3 were compared in all groups. Infarct size was significantly reduced in RIPC and UAG groups, compared to the other groups. Plasma levels of UAG in RIPC and UAG groups were significantly increased after RIPC and UAG administration, respectively. The cardioprotective effects of RIPC and UAG were accompanied by an increase in phosphorylation of STAT3 and abolished by AG490. This study indicated that RIPC reduces myocardial ischemia and reperfusion injury through UAG-induced activation of JAK/STAT pathway. UAG may be one of the humoral factors involved in the cardioprotective effects of RIPC.

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  • Difficult airway management of a patient with limited range of motion in the temporomandibular joint and cervical extension caused by psoriatic arthritis: a case report. International journal

    Makishi Maeda, Tomohiro Chaki, Ryoichi Kawaguchi, Tomohiko Kimijima, Michiaki Yamakage

    JA clinical reports   6 ( 1 )   44 - 44   2020.6

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    BACKGROUND: Psoriasis vulgaris, a chronic inflammatory skin disease, rarely causes temporomandibular arthritis. We report a case of difficult airway management of a patient with limited range of motion in the temporomandibular joint and cervical extension caused by psoriatic arthritis. CASE PRESENTATION: A 33-year-old man was scheduled to undergo laparoscopic colectomy. On admission, he was diagnosed with psoriatic arthritis. After induction of general anesthesia, we attempted intubation using Pentax Airway Scope® with a thin intlock blade and using a bronchoscope, but it was impossible because of the limited oral space and mandibular elevation. Because of concerns about cannot intubate, cannot ventilate, we antagonized the neuromuscular block and he emerged from general anesthesia. Finally, we succeeded in awake intubation via the nasal cavity using a bronchoscope under spontaneous respiration. CONCLUSIONS: Although psoriasis vulgaris is very rarely associated with temporomandibular arthritis, anesthesiologists should consider that it can cause perioperative difficult airways.

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  • Comparison of Mill Suss™-guided radial artery catheterization with the long-axis in-plane ultrasound-guided method under general anesthesia: a randomized controlled trial

    Michiko Osuda, Mitsutaka Edanaga, Tomomi Matsumoto, Asuka Yamamoto, Saki Ihara, Satoru Tanaka, Michiaki Yamakage

    Journal of Anesthesia   34 ( 3 )   464 - 467   2020.6

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    DOI: 10.1007/s00540-020-02749-z

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  • Video Glasses Reduce Preoperative Anxiety Compared With Portable Multimedia Player in Children: A Randomized Controlled Trial. International journal

    Yuki Hashimoto, Tomohiro Chaki, Naoyuki Hirata, Yasuyuki Tokinaga, Yusuke Yoshikawa, Michiaki Yamakage

    Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses   35 ( 3 )   321 - 325   2020.6

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    PURPOSE: Preoperative anxiety in children is challenging for anesthesia providers and nurses. The use of video glasses (VG), an immersive head mount display, helps conceal the unfamiliar operating room environment from the patient's visual field. The aim of this study was to determine the anxiolytic effect of VG compared with that of a portable multimedia player (PMP) during the preoperative period in children. DESIGN: Prospective randomized trial. METHODS: Participants were randomized into VG or PMP groups. Patients watched their favorite animation videos using the allocated device from the time of entering the preanesthetic holding area to the end of anesthetic induction. We evaluated modified Yale Preoperative Anxiety Scale scores during anesthetic induction. FINDINGS: The modified Yale Preoperative Anxiety Scale score in the VG group was significantly lower than that in the PMP group (P = .001). CONCLUSIONS: In children, the anxiolytic effect of VG during the preoperative period is larger than that of PMP.

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  • Recombinant human soluble thrombomodulin is associated with attenuation of sepsis-induced renal impairment by inhibition of extracellular histone release

    Masayuki Akatsuka, Yoshiki Masuda, Hiroomi Tatsumi, Michiaki Yamakage

    PLoS ONE   15 ( 1 )   2020.1

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    DOI: 10.1371/journal.pone.0228093

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  • International multicentre review of perioperative management and outcome for catecholamine-producing tumours. International journal

    H Groeben, M K Walz, B J Nottebaum, P F Alesina, A Greenwald, R Schumann, M W Hollmann, L Schwarte, M Behrends, T Rössel, C Groeben, M Schäfer, A Lowery, N Hirata, M Yamakage, J A Miller, T J Cherry, A Nelson, C C Solorzano, B Gigliotti, T S Wang, J K G Wietasch, P Friederich, B Sheppard, P H Graham, T N Weingarten, J Sprung

    The British journal of surgery   107 ( 2 )   e170-e178   2020.1

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    BACKGROUND: Surgery for catecholamine-producing tumours can be complicated by intraoperative and postoperative haemodynamic instability. Several perioperative management strategies have emerged but none has been evaluated in randomized trials. To assess this issue, contemporary perioperative management and outcome data from 21 centres were collected. METHODS: Twenty-one centres contributed outcome data from patients who had surgery for phaeochromocytoma and paraganglioma between 2000 and 2017. The data included the number of patients with and without α-receptor blockade, surgical and anaesthetic techniques, complications and perioperative mortality. RESULTS: Across all centres, data were reported on 1860 patients with phaeochromocytoma or paraganglioma, of whom 343 underwent surgery without α-receptor blockade. The majority of operations (78·9 per cent) were performed using minimally invasive techniques, including 16·1 per cent adrenal cortex-sparing procedures. The cardiovascular complication rate was 5·0 per cent overall: 5·9 per cent (90 of 1517) in patients with preoperative α-receptor blockade and 0·9 per cent (3 of 343) among patients without α-receptor blockade. The mortality rate was 0·5 per cent overall (9 of 1860): 0·5 per cent (8 of 517) in pretreated and 0·3 per cent (1 of 343) in non-pretreated patients. CONCLUSION: There is substantial variability in the perioperative management of catecholamine-producing tumours, yet the overall complication rate is low. Further studies are needed to better define the optimal management approach, and reappraisal of international perioperative guidelines appears desirable.

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  • Successful Anesthetic Management Using Dexmedetomidine Sequentially with Propofol in the Asleep-Awake-Asleep Technique for Elderly Patients Undergoing Awake Craniotomy. International journal

    Shunsuke Tachibana, Soichi Tanaka, Michiaki Yamakage

    Case reports in anesthesiology   2020   6795363 - 6795363   2020

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    Anesthesiologists should supply proper sedation and high-quality awakening in awake craniotomy anesthesia. At our institution, we perform an asleep-awake-asleep technique for awake craniotomy anesthesia by using short-acting anesthetic drugs, such as propofol and remifentanil. However, elderly patients do not wake adequately in our normal protocol and hence are unable to complete the required neurological tasks. In this case series, we present the anesthetic management of three elderly patients with sequent use of propofol and dexmedetomidine as sedative agents for awake craniotomy. We hypothesized that this anesthetic protocol is advantageous in awake craniotomy management. For the awake phase, all patients were adequately awake and performed neurological tasks without adverse events and agitation. The use of dexmedetomidine sequentially with propofol in an asleep-awake-asleep technique for awake craniotomy in elderly patients might shorten the time to awakening and provide clear awakening.

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  • 内視鏡室での鎮静について

    上嶋 浩順, 平田 直之, 山蔭 道明

    臨床麻酔   43 ( 12 )   1641 - 1643   2019.12

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  • Individualized nutritional treatment for acute stroke patients with malnutrition risk improves functional independence measurement: A randomized controlled trial. Reviewed

    Otsuki I, Himuro N, Tatsumi H, Mori M, Niiya Y, Kumeta Y, Yamakage M

    Geriatrics & gerontology international   20 ( 3 )   176 - 182   2019.12

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    AIM: The aim of the present study was to investigate the effects of individualized nutritional treatment on the activities of daily living of acute stroke patients. METHODS: This was a randomized controlled study. The eligibility criteria were acute stroke, age >65 years and the presence of malnutrition risk. Between September 2016 and December 2017, 128 patients were assigned to either the standard or intensive group (individualized nutritional treatment). The intensive group received energy that was calculated using the Harris-Benedict equation. The main outcome measures were the total functional independence measurement gain from the time of assignment to the time of discharge from the recovery hospital or at 3 months after the stroke onset, and motor and cognitive functional independence measurement gains. RESULTS: Compared with the standard group, the intensive group had significantly higher median energy intake (P < 0.001); significantly greater functional independence measurement gains in the total score (42 vs. 22; P = 0.02) and motor subscore (P = 0.01), but similar cognitive subscore. CONCLUSION: Individualized nutritional treatment improved the activities of daily living of older acute stroke patients with malnutrition risk. Geriatr Gerontol Int 2019; ••: ••-••.

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  • 非がん性慢性痛患者が日本でオピオイド治療を受けながら生きる体験 グランデッドセオリー研究(Patients living with chronic non-cancer pain receiving opioid therapy in Japan: a grounded theory study)

    進藤 ゆかり, 青柳 道子, 岩崎 創史, 山蔭 道明

    札幌医学雑誌   88 ( 1-6 )   53 - 64   2019.12

  • Lipid emulsion, but not propofol, induces skeletal muscle damage and lipid peroxidation.

    Tomohiro Chaki, Naoyuki Hirata, Yusuke Yoshikawa, Shunsuke Tachibana, Yasuyuki Tokinaga, Michiaki Yamakage

    Journal of anesthesia   33 ( 6 )   628 - 635   2019.12

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    PURPOSE: Prolonged propofol infusion induces skeletal muscle damage. However, it is well known that the lipid emulsion that is the solvent of propofol causes various types of tissue damage via lipid peroxidation, and that propofol, conversely, has an anti-lipid peroxidative effect. The purpose of this study was to determine whether propofol or the lipid emulsion is the cause of muscle damage following prolonged administration. METHODS: Rats were divided into four groups: NI group (no intervention), Cath group (venous catheter insertion only), Prop group (1% propofol (Maruishi) intravenous infusion at 10 mg/kg/h), and Lipid group (10% Lipofundin® intravenous infusion at 100 mg/kg/h) (n = 10, each group). 1% Propofol (Maruishi) or Lipofundin was infused at 1 mL/kg/h for 72 h. The solvent of 1% propofol (Maruishi) is a 10% lipid emulsion. Lipofundin consists of 50% long-chain triacylglycerols and 50% medium-chain triacylglycerols, similar to the propofol solvent. Plasma concentrations of creatine kinase and myoglobin, superoxide production level, and 4-hydroxynonenal and malondialdehyde expression in the gastrocnemius muscle were evaluated 72 h after the interventions. RESULTS: Plasma concentrations of creatine kinase and myoglobin in the Lipid group were significantly higher than those in the other three groups. The superoxide production level, and 4-hydroxynonenal and malondialdehyde expression in the Lipid group were also significantly higher than in the other three groups. CONCLUSION: Lipofundin induces skeletal muscle damage via lipid peroxidation, and 1% propofol (Maruishi) conversely suppresses the muscle damage via antioxidant effects.

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  • Sevoflurane Promotes Regeneration of the Endothelial Glycocalyx by Upregulating Sialyltransferase

    Satoshi Kazuma, Yasuyuki Tokinaga, Motonobu Kimizuka, Ryu Azumaguchi, Kohsuke Hamada, Michiaki Yamakage

    Journal of Surgical Research   241   40 - 47   2019.9

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    DOI: 10.1016/j.jss.2019.03.018

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  • セボフルランは心保護効果を持つ非アシル化グレリンの分泌を促進し、虚血再灌流障害の軽減に関与する

    澤下 泰明, 平田 直之, 吉川 裕介, 寺田 拡文, 山蔭 道明

    Cardiovascular Anesthesia   23 ( Suppl. )   [F - 3]   2019.9

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  • 人工心肺使用心臓手術後の高乳酸血症は急性腎障害の予測因子となるか?

    長谷川 源, 平田 直之, 山蔭 道明

    Cardiovascular Anesthesia   23 ( Suppl. )   [DP2 - 03]   2019.9

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  • Comparative Study of TOF-Cuff, a New Neuromuscular Blockade Monitor, and TOF-Watch, an Acceleromyography

    Satoshi Kazuma, Keiko Wakasugi, Hiroya Hagiwara, Michiaki Yamakage

    Anesthesia and Analgesia   129 ( 1 )   E16 - E19   2019.7

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    DOI: 10.1213/ANE.0000000000004147

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  • Association Between Motor-Evoked Potentials and Spinal Cord Damage Diagnosed With Magnetic Resonance Imaging After Thoracoabdominal and Descending Aortic Aneurysm Repair. Reviewed International journal

    Kohshi Hattori, Kenji Yoshitani, Shinya Kato, Masahiko Kawaguchi, Mikito Kawamata, Manabu Kakinohana, Yoshitsugu Yamada, Michiaki Yamakage, Kimitoshi Nishiwaki, Shunsuke Izumi, Yusuke Yoshikawa, Yoshiteru Mori, Kazuko Hasegawa, Yoshihiko Onishi

    Journal of cardiothoracic and vascular anesthesia   33 ( 7 )   1835 - 1842   2019.7

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

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  • Successful awake craniotomy in an aged patient with a severe hearing impairment using a bone conduction voice amplifier: a case report. International journal

    Shunsuke Tachibana, Masahito Omote, Michiaki Yamakage

    JA clinical reports   5 ( 1 )   37 - 37   2019.6

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    BACKGROUND: The main purposes of awake craniotomy are to minimize postoperative brain dysfunction caused by the surgical procedure and to maximize the tumor resection range. In awake craniotomy, it is important to have a good quality of awakening and to obtain patient's obedience in the awake phase. CASE PRESENTATION: The patient was a 75-year-old woman with an advanced hearing impairment who was scheduled for awake craniotomy. We used a bone conduction voice amplifier before and during the awake phase and communicated with the patient smoothly. CONCLUSIONS: We were able to complete awake craniotomy fully, and overcoming the deafness problem might have contributed to the patient's good outcome. This case report indicates that awake craniotomy can be performed in a patient with an advanced hearing impairment under the condition of careful anesthetic management.

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  • Efficacy and Practicality of Opioid Therapy in Japanese Chronic Noncancer Pain Patients. International journal

    Yukari Shindo, Soushi Iwasaki, Michiaki Yamakage

    Pain management nursing : official journal of the American Society of Pain Management Nurses   20 ( 3 )   222 - 231   2019.6

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    BACKGROUND: Many Japanese adults suffer from chronic pain. However, 50% of these individuals discontinue treatment despite the persistence of pain. Both clinicians and patients in Japan tend to be concerned about the safety and efficacy of opioid therapy, and the use of opioids in chronic non-cancer pain remains less common in Japan than elsewhere. AIMS: This study examined the effects of opioid therapy on the daily lives of patients with chronic noncancer pain in Japan, where use of opioids for this type of pain remains uncommon. DESIGN: Prospective cross-sectional questionnaire study. SETTING: Data were collected over two periods, between March and April 2014 at one hospital, and between February and April 2015 at the other hospital. Subjects were recruited at the respective clinics by the study interviewer between March 1, 2014 and April 15, 2014 and between February 1, 2015 and April 15, 2015. PARTICIPANTS/SUBJECTS: This study included 34 outpatients with chronic non-cancer pain who were being treated with opioid analgesics at pain clinics in two hospitals in Sapporo. METHODS: Thirty-four Japanese patients receiving opioid medications for chronic noncancer pain in outpatient pain clinics were enrolled. Participants underwent interviews and completed the Japanese versions of the Short Form 36 (SF-36v2) and the Coping Strategies Questionnaire (CSQ). RESULTS: Sleep disruption, claiming compensation for work-related accidents, and current pain level were negatively correlated with opioid effectiveness (p < .05). Additionally, opioid effectiveness was negatively correlated with the catastrophizing subscale of the CSQ (r = -0.50, p < .01). The effects of opioid therapy had a low positive correlation with the emotional functioning role subscale of the SF-36v2 (r = 0.38, p < .05). Daily equivalent morphine dose was positively correlated with opioid therapy duration, interference with appetite, and current pain intensity. Morphine dose was also positively correlated with scores for the catastrophizing subscale of the CSQ (r = 0.36, p < .05) and negatively correlated with scores in all subdomains of the SF-36v2. CONCLUSIONS: It is important to focus on adaptive, cognitive, and emotional factors, such as emotional role functioning, to determine the efficacy of opioid treatment for chronic noncancer pain. Moreover, patients with catastrophizing significantly increased their morphine doses, resulting in an increased risk of overdose.

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  • Using the Bair Hugger™ temperature monitoring system in neck and chest regions: a pilot study. International journal

    Shunsuke Tachibana, Yutaro Chida, Michiaki Yamakage

    JA clinical reports   5 ( 1 )   32 - 32   2019.5

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    PURPOSE: Temperature monitoring in the perioperative periods is important in order to avoid both hyperthermia and hypothermia. In our pilot study, we evaluated the usefulness of Bair Hugger™ temperature monitoring system (BHTMS), a forehead deep temperature monitoring system, in the neck and chest under general anesthesia. METHODS: After approval from the Sapporo Medical University Research Ethics Board, 30 female patients scheduled for laparoscopic surgery were enrolled in this study. Patients were divided into three groups, depending on the attachment regions of BHTMS sensor. Temperatures obtained from the three regions and each esophageal temperature (TEso) were monitored and analyzed. RESULTS: A Bland-Altman plot showed that the mean bias between temperature obtained from the neck and TEso was + 0.05 °C above TEso (2SD ± 0.35 °C), and that between temperature obtained from the chest and TEso was - 0.55 °C above TEso (2SD ± 0.55 °C). CONCLUSION: By using the BHTMS sensor in the neck region, it is possible to monitor core body temperature seamlessly and with high reliability. These results may suggest that the use of BHTMS has high versatility in measuring perioperative core body temperature. TRIAL REGISTRATION: This study was approved by the Sapporo Medical University Research Ethics Board (2015: No. 262-149) and registered with UMIN Clinical Trial Registry ( UMIN000016802 Registered 15 March 2015).

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  • Identification of Candidate Genes and Pathways in Dexmedetomidine-Induced Cardioprotection in the Rat Heart by Bioinformatics Analysis. International journal

    Yusuke Yoshikawa, Naoyuki Hirata, Hirofumi Terada, Yasuaki Sawashita, Michiaki Yamakage

    International journal of molecular sciences   20 ( 7 )   2019.4

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    Dexmedetomidine (DEX), a highly selective alpha2 adrenergic receptor agonist, directly protects hearts against ischemia/reperfusion (I/R) injury. However, the detailed mechanism has not been fully elucidated. We studied differentially expressed mRNAs and miRNAs after DEX administration in rat hearts by comprehensive analysis. Additionally, bioinformatics analysis was applied to explore candidate genes and pathways that might play important roles in DEX-induced cardioprotection. The results of microarray analysis showed that 165 mRNAs and 6 miRNAs were differentially expressed after DEX administration. Through bioinformatics analysis using differentially expressed mRNAs, gene ontology (GO) terms including MAP kinase tyrosine/serine/threonine phosphatase activity and pathways including the p53 pathway were significantly enriched in the down-regulated mRNAs. Dusp1 and Atm were associated with the GO term of MAP kinase tyrosine/serine/threonine phosphatase activity and the p53 pathway, respectively. On the other hand, no significant pathway was found in the target mRNAs of deregulated miRNAs. The results indicated some possible key genes and pathways that seem to be of significance in DEX-induced cardioprotection, although miRNAs seem to be unlikely to contribute to cardioprotection induced by DEX.

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  • Continuous rectus sheath block in a patient with a postoperative rectus sheath hematoma: a case report. International journal

    Sho Kumita, Shunsuke Tachibana, Takahiro Ichimiya, Michiaki Yamakage

    JA clinical reports   5 ( 1 )   16 - 16   2019.3

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    BACKGROUND: Severe abdominal pain caused by a rectus sheath hematoma (RSH) can decrease a patient's activities of daily living. A case of postoperative RSH for which a continuous rectus sheath block (RSB) was effective is reported. CASE PRESENTATION: A 62-year-old woman who had no previous medical history underwent hysterectomy, total cystectomy, and ileal conduit surgery for bladder cancer under epidural and general anesthesia. She complained of severe abdominal pain 40 min after removal of the epidural catheter on postoperative day (POD) 4. Computed tomography showed an RSH on POD 12. For pain relief, an ultrasound-guided continuous RSB was performed on POD 17. After the block, the numerical rating scale (NRS) score during movement decreased immediately (from 10 to 2 or 3), and she had no further need for oral or intravenous analgesics. She was discharged from the hospital without any complications on POD 28. CONCLUSIONS: Continuous RSB can be an effective technique for pain relief of postoperative RSH.

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  • The Impact of Air Transport for Acute Coronary Syndrome Patients. Reviewed International journal

    Homma H, Niiyama Y, Sonoda H, Himuro N, Yamakage M

    Air medical journal   38 ( 2 )   73 - 77   2019.3

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    OBJECTIVE: For patients with acute coronary syndrome (ACS), percutaneous coronary intervention (PCI) within 120 minutes from onset is recommended. A helicopter emergency medical service (HEMS) is useful for transporting ACS patients. The purposes of this study were to investigate whether patients with ACS in the eastern part of Hokkaido could be transported to a PCI hospital by HEMS and undergo PCI within 120 minutes and to clarify the factors most related to delayed access to PCI. METHODS: This was a retrospective cohort study that analyzed 513 patients diagnosed with ACS at our institution, an HEMS base/PCI hospital. We investigated transport modes for each patient and identified the processes by which access to PCI was delayed. RESULTS: HEMS reduced transport time compared with ground emergency medical services but did not contribute to access to PCI within 120 minutes. The most important factor was transport directly to a PCI hospital (P < .01). CONCLUSION: HEMS did not achieve a total transport time of patients to a PCI hospital within 120 minutes from onset. Transport using HEMS is insufficient to access early PCI; patient condition must also be considered to determine whether to go through a non-PCI hospital.

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  • The Influence of Anesthesia on Corticocortical Evoked Potential Monitoring Network Between Frontal and Temporoparietal Cortices. Reviewed International journal

    Yuto Suzuki, Rei Enatsu, Aya Kanno, Rintaro Yokoyama, Hime Suzuki, Shunsuke Tachibana, Yukinori Akiyama, Takeshi Mikami, Satoko Ochi, Michiaki Yamakage, Nobuhiro Mikuni

    World neurosurgery   123   e685-e692   2019.3

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    BACKGROUND: Previous studies have reported the usefulness of intraoperative corticocortical evoked potentials (CCEPs) for preserving language function during brain surgery. OBJECTIVE: This study aimed to assess the influence of depth of anesthesia on CCEP to establish its clinical utility. METHODS: Twenty patients with brain tumors or epilepsy who underwent awake craniotomy were included in this study. Before resection, the electrode plates were placed on the frontal and temporoparietal cortices, and 1-Hz alternating electrical stimuli were delivered to the pars opercularis/pars triangularis in a bipolar fashion. Electrocorticograms from the temporoparietal cortices time-locked to stimuli were averaged to obtain CCEP responses from a state of deep anesthesia until the awake state. The correlation between CCEP waveforms and bispectral index (BIS) was evaluated. RESULTS: CCEP amplitude increased with the increase in the BIS level. CCEP latency decreased in 5 patients and increased in 15 patients under anesthesia compared with the awake state. CCEP amplitudes decreased by 11.3% to 75.2% (median 31.3%) under anesthesia with <65 BIS level. These differences were statistically significant (P < 0.01, Wilcoxon signed-rank test). With respect to CCEP latencies, there was no significant difference between the awake and anesthetic states. CONCLUSIONS: CCEP amplitudes were correlated with depth of anesthesia, whereas CCEP latencies were not affected by anesthesia. The influence of anesthesia should be considered when applying this technique to intraoperative monitoring.

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  • Dexmedetomidine attenuates surgery-induced cognitive deficit and hippocampal Mapt expression in aged mice

    Shunsuke Tachibana, Tomo Hayase, Michiaki Yamakage

    Sapporo Medical journal   88 ( 1-6 )   65 - 76   2019.1

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    DOI: 10.15114/smj.88.65

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  • Evaluation of pre- and post-dilution continuous veno-venous hemofiltration on leukocyte and platelet function in patients with sepsis

    Shinya Chihara, Yoshiki Masuda, Hiroomi Tatsumi, Michiaki Yamakage

    International Journal of Artificial Organs   42 ( 1 )   9 - 16   2019.1

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    DOI: 10.1177/0391398818801292

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  • Chronological change in oropharyngeal leak pressure of pediatric i-gel™. International journal

    Yusuke Yoshikawa, Naoyuki Hirata, Yuko Nawa, Michiaki Yamakage

    Paediatric anaesthesia   29 ( 1 )   107 - 108   2019.1

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    DOI: 10.1111/pan.13546

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  • Anesthetic Management of Total Aortic Arch Replacement in a Myasthenia Gravis Patient under Deep Hypothermic Circulatory Arrest. International journal

    Mamiko Kondo, Yusuke Yoshikawa, Hirofumi Terada, Michiaki Yamakage

    Case reports in anesthesiology   2019   3278147 - 3278147   2019

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    The anesthetic management of myasthenia gravis patients undergoing cardiac or aortic surgery under cardiopulmonary bypass, especially with deep hypothermic circulatory arrest, is challenging. We describe a case of successful anesthetic management of a myasthenia gravis patient undergoing total arch replacement with deep hypothermic circulatory arrest under neuromuscular monitoring and complete reversal of the action of neuromuscular blocking drugs by sugammadex. The present case suggests that patients with well-controlled myasthenia gravis might be safely managed in cardiac or aortic surgery under cardiopulmonary bypass with deep hypothermic circulatory arrest.

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  • Epidural anesthesia combined with sedation with dexmedetomidine for appendectomy in a patient with amyotrophic lateral sclerosis: a case report. International journal

    Mikako Kusakai, Atsushi Sawada, Natsumi Kii, Yasuyuki Tokinaga, Naoyuki Hirata, Michiaki Yamakage

    JA clinical reports   4 ( 1 )   82 - 82   2018.12

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    BACKGROUND: Patients with amyotrophic lateral sclerosis (ALS) present increased risks for anesthesia-related complications. We present a case of epidural anesthesia combined with sedation with dexmedetomidine for open appendectomy in a patient with ALS who refused invasive mechanical ventilation. CASE PRESENTATION: A 50-year-old man with a 3-year history of ALS was scheduled to undergo open appendectomy due to repeated appendicitis. He refused to undergo invasive mechanical ventilation using an endotracheal tube. Hence, we decided to administer epidural anesthesia combined with sedation with dexmedetomidine for anesthesia during the surgical procedure. The patient underwent open appendectomy without complications and with no pain or discomfort during surgery. There were no neurological complications at the 3-month follow-up after surgery. CONCLUSIONS: Epidural anesthesia combined with sedation with dexmedetomidine may be effective for the anesthetic management of patients who would benefit from regional anesthesia.

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  • Dexmedetomidine Does Not Affect Platelet Function Measured With TEG 6S and Platelet Mapping Assay in Whole Blood. International journal

    Yusuke Yoshikawa, Kanako Takahashi, Mitsutaka Edanaga, Naoyuki Hirata, Michiaki Yamakage

    Journal of cardiothoracic and vascular anesthesia   32 ( 6 )   e9-e11   2018.12

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  • 経皮的心肺補助下に緊急気管切開術を施行した甲状腺腫瘍の1症例

    横山 竜也, 新山 幸俊, 吉川 裕介, 高田 幸昌, 山蔭 道明

    麻酔   67 ( 11 )   1213 - 1215   2018.11

  • The eutectic mixture local anesthetics (EMLA) cream is more effective on venipuncture pain compared with lidocaine tape in the same patients. International journal

    Tomomi Matsumoto, Tomohiro Chaki, Naoyuki Hirata, Michiaki Yamakage

    JA clinical reports   4 ( 1 )   73 - 73   2018.10

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    INTRODUCTION: Although venous cannulation is imperative during perioperative period, it inevitably causes venipuncture pain. Eutectic mixture local anesthetics (EMLA) has been used to reduce this pain, and various studies have been conducted to evaluate the efficacy of EMLA. But these studies did not elucidate the effect of EMLA exactly, because there were large individual differences in pain sensitivity. The aim of this study is to accurately evaluate the efficacy of EMLA cream for venipuncture pain relief compared with lidocaine tape in the same patients. METHODS: Participants were randomly allocated into EL or LE group. Participants received EMLA cream at one side dorsum of hand and lidocaine tape at another dorsum of hand before entering operation room. Local anesthetics were strictly applied according to their manufacturers' instruments, respectively. In the EL group, participants received venipuncture at EMLA cream site firstly. In LE group, participants, conversely, received venipuncture at lidocaine tape site firstly. Before anesthetic induction, local anesthetics were removed followed by venous cannulations. After cannulation, participants evaluated the pain by visual analog scale (VAS) and verbal rating scale (VRS).The primary outcome was VAS, and the secondary outcome was VRS. RESULTS: Data from 24 patients were analyzed. The VAS of EMLA cream was significantly lower than that of lidocaine tape (4 [0-18] vs 17 [8-45], p = 0.001, 95% CI - 25 to - 6). The VRS of EMLA cream was also significantly lower than that of lidocaine tape (2 [1-2] vs 2 [2-3], p = 0.002, 95% CI - 0.8 to - 0.2). The local skin adverse events were observed in five patients at EMLA cream applied hands. CONCLUSIONS: We conducted a comparative study to elucidate the efficacy of EMLA cream for venipuncture-pain comparing with lidocaine tape in the same patients. Our results strongly suggest that EMLA cream is more effective for venipuncture pain relief than lidocaine tape. TRIAL REGISTRATIONS: UMIN Clinical Trials Registry, UMIN000023030 . Registered 5 July 2016.

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  • Does the new disinfectant (Olanexidine Gluconate) reduce SSI ?

    Tomomi Matsumoto, Yuki Hashimoto, Shino Tonosaki, Mitsuru Uduki, Shoji Kawachi, Michiaki Yamakage

    Japanese Journal of Anesthesiology   67 ( 10 )   1093 - 1096   2018.10

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  • Superior sealing effect of a three-dimensional printed modified supraglottic airway compared with the i-gel in a three-dimensional printed airway model

    Tomohiko Kimijima, Mitsutaka Edanaga, Michiaki Yamakage

    Journal of Anesthesia   32 ( 5 )   655 - 662   2018.10

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    DOI: 10.1007/s00540-018-2531-7

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  • 妊娠高血圧症を合併した多発性硬化症の妊婦に硬膜外麻酔のみで帝王切開を施行した1症例

    佐藤 優真, 君塚 基修, 吉川 裕介, 枝長 充隆, 山蔭 道明

    日本臨床麻酔学会誌   38 ( 6 )   S297 - S297   2018.10

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  • Sonoclotで無輸血手術が可能となった血小板増加症を合併した大動脈弁輪拡張症の1症例

    畠山 陽介, 枝長 充隆, 吉川 裕介, 松本 友美, 寺田 拡文, 木井 菜摘, 山蔭 道明

    Cardiovascular Anesthesia   22 ( Suppl. )   257 - 257   2018.9

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  • Removal of artificial denture as an airway foreign body under general anesthesia

    Shino Tonozaki, Mitsuru Uzuki, Shoji Kawachi, Michiaki Yamakage

    Japanese Journal of Anesthesiology   67 ( 8 )   825 - 828   2018.8

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  • In reply: Why remifentanil?

    Wataru Sakai, Yusuke Yoshikawa, Michiaki Yamakage

    Journal of anesthesia   32 ( 3 )   459 - 459   2018.6

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

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

    ANESTHESIA AND ANALGESIA   126 ( 3 )   763 - 768   2018.3

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    DOI: 10.1213/ANE.0000000000002749

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  • Perioperative respiratory complications: current evidence and strategy discussed in 2017 JA symposium

    K. Hirota, M. Yamakage, S. Hashimoto, T. Asai, S. Isono

    Journal of Anesthesia   32 ( 1 )   132 - 136   2018.2

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  • Dexmedetomidine Maintains Its Direct Cardioprotective Effect Against Ischemia/Reperfusion Injury in Hypertensive Hypertrophied Myocardium. International journal

    Yusuke Yoshikawa, Naoyuki Hirata, Ryoichi Kawaguchi, Yasuyuki Tokinaga, Michiaki Yamakage

    Anesthesia and analgesia   126 ( 2 )   443 - 452   2018.2

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    BACKGROUND: Dexmedetomidine (DEX) has a direct cardioprotective effect against ischemia/reperfusion injury through endothelial nitric oxide synthase (eNOS) phosphorylation via α2-adrenoreceptor (α2-AR). By using spontaneously hypertensive rat (SHR) and Wistar-Kyoto (WKY) rat models, the cardioprotective effect of DEX in hypertrophied myocardium and the differential characteristics of cardiac α2-AR and the I1 imidazoline receptor (I1R) were examined. METHODS: Langendorff-perfused rat hearts underwent 40 minutes of global ischemia followed by 120 minutes of reperfusion in the presence or absence of DEX before ischemia. Infarct size was measured, and eNOS phosphorylation was assessed by Western blotting. The presence and expression of the receptors were assessed by immunohistochemistry, real-time reverse transcriptase polymerase chain reaction, and Western blotting. RESULTS: In WKY, DEX significantly decreased infarct size and increased phosphorylated-eNOS/eNOS. These effects were counteracted by yohimbine (α2-AR antagonist) and efaroxan (α2-AR and I1R antagonist). In SHR, DEX significantly decreased infarct size, and the effect was counteracted by efaroxan but not yohimbine. DEX did not alter phosphorylated-eNOS/eNOS in SHR. α2-AR and I1R were observed in WKY and SHR hearts. Although alpha2A-AR and alpha2B-AR messenger RNA and protein levels were upregulated in SHR, I1R expression was comparable between the 2 species. CONCLUSIONS: In the hypertrophied heart, DEX maintains its direct cardioprotective effect against ischemia/reperfusion injury via I1R in an eNOS-nondependent manner despite upregulation of α2-AR.

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  • Desflurane inhibits endothelium-dependent vasodilation more than sevoflurane with inhibition of endothelial nitric oxide synthase by different mechanisms

    Satoshi Kazuma, Yasuyuki Tokinaga, Yukimasa Takada, Ryu Azumaguchi, Motonobu Kimizuka, Shunsuke Hayashi, Michiaki Yamakage

    Biochemical and Biophysical Research Communications   495 ( 1 )   217 - 222   2018.1

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    DOI: 10.1016/j.bbrc.2017.11.017

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  • Angiotensin II Receptor Blocker versus Angiotensin-Converting Enzyme Inhibitor for Postoperative Acute Kidney Injury after Cardiac Surgery

    Wataru Sakai, Naoyuki Hirata, Michiaki Yamakage

    Journal of Anesthesia & Clinical Research   09 ( 05 )   2018

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  • Nitrite administration improves sepsis-induced myocardial and mitochondrial dysfunction by modulating stress signal responses Reviewed

    Ryoichi Kawaguchi, Naoyuki Hirata, Yasuyuki Tokinaga, Shunsuke Hayashi, Shigeaki Inoue, Nobuo Watanabe, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   31 ( 6 )   885 - 894   2017.12

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    DOI: 10.1007/s00540-017-2417-0

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  • Three cases of implantation of a SureScan(A (R)) system and MRI for investigating causes of pain Reviewed

    Kazunobu Takahashi, Atsushi Sawada, Soshi Iwasaki, Naoya Yama, Hiroyuki Takashima, Maki Onodera, Masamitsu Hatakenaka, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   31 ( 6 )   915 - 917   2017.12

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  • Effect of remifentanil during cardiopulmonary bypass on incidence of acute kidney injury after cardiac surgery Reviewed

    Wataru Sakai, Yusuke Yoshikawa, Naoyuki Hirata, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   31 ( 6 )   895 - 902   2017.12

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    DOI: 10.1007/s00540-017-2419-y

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  • Injection Volume and Anesthetic Effect in Serratus Plane Block

    Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage

    Regional Anesthesia and Pain Medicine   42 ( 6 )   737 - 740   2017.11

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  • 高度肥満患者 綿密な麻酔計画が良好な麻酔計画を左右する!

    熱田 真穂, 枝長 充隆, 新山 幸俊, 山蔭 道明

    日本臨床麻酔学会誌   37 ( 6 )   S302 - S302   2017.10

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  • 限局性の下行大動脈解離が生じたバルーン大動脈弁形成術(BAV)の1症例

    佐藤 慧, 吉川 裕介, 茶木 友浩, 枝長 充隆, 山蔭 道明

    Cardiovascular Anesthesia   21 ( Suppl. )   362 - 362   2017.9

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  • Less postoperative sore throat after nasotracheal intubation using a fiberoptic bronchoscope than using a Macintosh laryngoscope: A double-blind, randomized, controlled study. International journal

    Nobuko Tachibana, Yukitoshi Niiyama, Michiaki Yamakage

    Journal of clinical anesthesia   39   113 - 117   2017.6

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    STUDY OBJECTIVE: To evaluate whether nasotracheal intubation using a fiberoptic bronchoscope reduces postoperative sore throat. DESIGN: Prospective, double-blinded, randomized, and controlled study. SETTING: Postoperative areas and surgical ward of a university hospital. PATIENTS: Seventy-four patients with American Society of Anesthesiologists physical status I-II who were scheduled for elective general anesthesia requiring nasotracheal intubation. INTERVENTIONS: Patients were randomized to one of two intubation groups, F (fiberoptic bronchoscope-guided) and M (Macintosh laryngoscope-guided), and after induction of general anesthesia, the patients' tracheas were intubated via the nose. MEASUREMENTS: The intensity of postoperative sore throat was evaluated using a numerical rating score (0=none, 10=severe) at 24 hours postoperatively, and the incidence of nasal mucosal trauma, time to completion of intubation, and hemodynamic responses were recorded and compared between groups. MAIN RESULTS: The numerical rating score value was significantly lower in group F than in group M (P=.0047), but the incidence of nasal mucosal trauma was comparable between the two groups. The median time to completion of intubation was shorter for group F than group M (P<.0001). Hemodynamic responses were not significantly different. CONCLUSIONS: Fiberoptic bronchoscope-guided intubation is associated with less sore throat after nasotracheal intubation than M intubation. The time to completion of intubation was significantly shorter using the fiberoptic bronchoscope than that using the Macintosh laryngoscope.

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  • Possible utility of contrast-enhanced ultrasonography for detecting spread of local anesthetic in nerve block Reviewed

    Hideaki Sasaki, Masanori Yamauchi, Takafumi Ninomiya, Haruyuki Tatsumi, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   31 ( 3 )   365 - 373   2017.6

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    DOI: 10.1007/s00540-017-2347-x

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  • 肺胞蛋白症に対する全肺洗浄における全身麻酔管理についての検討

    笠羽 一敏, 吉川 裕介, 山蔭 道明

    麻酔科学サマーセミナー   14回   39 - 39   2017.6

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  • Early induction of direct hemoperfusion with a polymyxin-B immobilized column is associated with amelioration of hemodynamic derangement and mortality in patients with septic shock

    Shinya Chihara, Yoshiki Masuda, Hiroomi Tatsumi, Kota Nakano, Tomokazu Shimada, Takao Murohashi, Michiaki Yamakage

    Journal of Artificial Organs   20 ( 1 )   71 - 75   2017.3

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    DOI: 10.1007/s10047-016-0922-9

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  • The influence of depth of anesthesia on motor evoked potential response during awake craniotomy. International journal

    Shunya Ohtaki, Yukinori Akiyama, Aya Kanno, Shouhei Noshiro, Tomo Hayase, Michiaki Yamakage, Nobuhiro Mikuni

    Journal of neurosurgery   126 ( 1 )   260 - 265   2017.1

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    OBJECTIVE Motor evoked potentials (MEPs) are a critical indicator for monitoring motor function during neurological surgery. In this study, the influence of depth of anesthesia on MEP response was assessed. METHODS Twenty-eight patients with brain tumors who underwent awake craniotomy were included in this study. From a state of deep anesthesia until the awake state, MEP amplitude and latency were measured using 5-train electrical bipolar stimulations on the same site of the precentral gyrus each minute during the surgery. The depth of anesthesia was evaluated using the bispectral index (BIS). BIS levels were classified into 7 stages: < 40, and from 40 to 100 in groups of 10 each. MEP amplitude and latency of each stage were compared. The deviation of the MEP measurements, which was defined as a fluctuation from the average in every BIS stage, was also considered. RESULTS A total of 865 MEP waves in 28 cases were evaluated in this study. MEP amplitude was increased and latency was decreased in accordance with the increases in BIS level. The average MEP amplitudes in the > 90 BIS level was approximately 10 times higher than those in the < 40 BIS level. Furthermore, the average MEP latencies in the > 90 BIS level were 1.5-3.1 msec shorter than those in the < 60 BIS level. The deviation of measured MEP amplitudes in the > 90 BIS level was significantly stabilized in comparison with that in the < 60 BIS level. CONCLUSIONS MEP amplitude and latency were closely correlated with depth of anesthesia. In addition, the deviation in MEP amplitude was also correlated with depth of anesthesia, which was smaller during awake surgery (high BIS level) than during deep anesthesia. Therefore, MEP measurement would be more reliable in the awake state than under deep anesthesia.

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  • Experimental and Clinical Evaluation of Predilution and Postdilution Continuous Venovenous Hemofiltration on Clearance Characteristics

    Shinya Chihara, Yoshiki Masuda, Michiaki Yamakage

    ASAIO Journal   63 ( 2 )   229 - 234   2017

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  • Remifentanil prevents increases of blood glucose and lactate levels during cardiopulmonary bypass in pediatric cardiac surgery. International journal

    Tomohiro Chaki, Yuko Nawa, Keishi Tamashiro, Eri Mizuno, Naoyuki Hirata, Michiaki Yamakage

    Annals of cardiac anaesthesia   20 ( 1 )   33 - 37   2017

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    INTRODUCTION: Cardiopulmonary bypass (CPB) can cause stress response that increases levels of cytokine and catecholamine in plasma, resulting in hyperglycemia. In adults, it has been demonstrated that remifentanil infusion during CPB could prevent increases of cytokine, catecholamine, and blood glucose levels, but such effects of remifentanil in children have not been elucidated. AIM: In this study, we investigated the preventive effects of remifentanil on blood glucose and lactate levels during CPB in children. MATERIALS AND METHODS: This retrospective study included children who underwent ventricular septal defect or atrial septal defect closure. Data for patients who did not receive, during CPB period, remifentanil infusion (non-Remi group) and patients who received remifentanil infusion at 0.5 μg/kg/min (Remi group) during CPB were used for analysis. Primary outcomes were lactate and blood glucose levels just before and after CPB. Data are presented as medians and interquartile ranges. Data were analyzed by the Mann-Whitney U-test and Chi-square test. A P < 0.05 was considered statistically significant. RESULTS: During CPB, 13 and 11 patients were allocated into Remi and non-Remi groups, respectively. Pre-CPB lactate and blood glucose levels were not significantly different between the two groups, but post-CPB lactate and blood glucose levels in the Remi group were significantly lower than that in the non-Remi group. CONCLUSION: 0.5 μg/kg/min remifentanil infusion during CPB suppresses the increases of blood glucose and lactate levels in children.

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  • Anesthetic management of a child with phosphomannomutase-2 congenital disorder of glycosylation (PMM2-CDG). International journal

    Wataru Sakai, Yusuke Yoshikawa, Yasuyuki Tokinaga, Michiaki Yamakage

    JA clinical reports   3 ( 1 )   8 - 8   2017

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    Background: Glycosylation is one of the major posttranslational modifications of proteins and it is essential for proteins to obtain normal biological functions. Congenital disorders of glycosylation (CDGs) are very rare genetic disorders that lack enzymes needed for glycosylation. Phosphomannomutase-2 (PMM2)-CDG is the most common type of CDG. CDGs can cause a wide variety of clinical symptoms in almost every organ system. Muscular hypotonia is often present in patients with CDGs and is one of the most notable problems for anesthetic management because the susceptibility to nondepolarizing neuromuscular blocking agents (NMBAs) in patients with CDGs is unknown. Case presentation: The patient was a 17-month-old boy who weighed 6.5 kg and was 71 cm tall. He presented for strabismus surgery. He had muscular hypotonia, mental retardation, hepatic dysfunction, mild cerebellar hypoplasia, and some dysmorphic features including inverted nipples and abnormal subcutaneous fat distribution of the hips. Gene analysis revealed a compound heterozygous mutation in the gene encoding PMM2 and the patient was diagnosed as having PMM2-CDG. General anesthesia was performed with sevoflurane, nitrous oxide, and rocuronium. Neuromuscular monitoring was performed during anesthesia using train-of-four (TOF)-Watch® (MSD, Japan). As postoperative analgesia, the surgeon performed sub-Tenon's anesthesia. We did not use any intravenous analgesic. After completion of the operation, residual rocuronium was competed by administration of sugammadex. The patient gained consciousness and spontaneous breathing was established shortly thereafter, and the trachea was smoothly extubated. He was transported to an inpatient ward and was discharged to his home the next day without any complication. Conclusions: We performed safe anesthetic management in a 17-month-old boy with PMM2-CDG using rocuronium under neuromuscular monitoring.A patient with PMM2-CDG may show nearly normal susceptibility to nondepolarizing NMBAs.

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  • Retrolaminar block: analgesic efficacy and safety evaluation Reviewed

    Takeshi Murouchi, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   30 ( 6 )   1003 - 1007   2016.12

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    DOI: 10.1007/s00540-016-2230-1

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  • Comparison of the clinical performances of Air-Qsp and i-Gel for airway management under general anesthesia with a muscle relaxant Reviewed

    Asako Watanabe, Mitsutaka Edanaga, Hiromichi Ichinose, Michiaki Yamakage

    JOURNAL OF CLINICAL ANESTHESIA   34   223 - 226   2016.11

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  • i-gelを介した気管支ファイバースコープガイド下気管挿管が有用であった高度挿管困難の1例

    千田 雄太郎, 立花 俊祐, 須貝 温子, 新山 幸俊, 山蔭 道明

    日本臨床麻酔学会誌   36 ( 6 )   S362 - S362   2016.10

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  • Continuous wound infiltration with 0.2% ropivacaine versus a single intercostal nerve block with 0.75% ropivacaine for postoperative pain management after reconstructive surgery for microtia. International journal

    Yukitoshi Niiyama, Takatoshi Yotsuyanagi, Michiaki Yamakage

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS   69 ( 10 )   1445 - 9   2016.10

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    BACKGROUND AND AIM: In reconstructive surgery for microtia during childhood, costal cartilage is used for pinna formation. Postoperative pain in the region from which the costal cartilage is taken is severe, which delays recovery after surgery. We evaluated prospectively whether continuous wound infiltration (CWI) of a local anesthetic (LA) reduces pain and enables rapid recovery compared with a single intercostal nerve block (ICNB). METHOD: Forty-eight patients were randomly divided into two groups. In Group I, a single ICNB with 10 ml of 0.75% ropivacaine was performed at the end of surgery. In Group C, a catheter was inserted into the space between the abdominal external oblique muscle and the rectus abdominis muscle. Then, a 0.4-ml/kg bolus of 0.2% ropivacaine was administered, followed by continuous infusion at 2-4 ml/h for 48 h. Postoperative pain intensity evaluated using the Face Scale, dose of supplemental analgesics, and time until mobilization were evaluated. In Group C, the plasma concentrations of ropivacaine were analyzed. RESULTS: The pain intensity at rest was significantly lower in Group C than in Group I, but the values during coughing were comparable. The number of patients receiving a supplemental analgesic and the median number of doses were significantly larger in Group I than in Group C (P = 0.029, P = 0.0007, respectively). The plasma concentrations of ropivacaine were within the safe range over 48 h. The times until mobilization were comparable. CONCLUSION: CWI of 0.2% ropivacaine is a better and safe technique for postoperative pain management after costal cartilage graft harvest in children.

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  • Effect of Intraoperative Glucose Infusion on Catabolism of Adipose Tissue and Muscle Protein in Patients Anesthetized With Remifentanil in Combination With sevoflurane During Major Surgery: A Randomized Controlled Multicenter Trial Reviewed

    Atsushi Sawada, Yasuhiro Kamada, Haruko Hayashi, Hiromichi Ichinose, Shinzo Sumita, Michiaki Yamakage

    ANESTHESIA AND ANALGESIA   123 ( 4 )   869 - 876   2016.10

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    DOI: 10.1213/ANE.0000000000001522

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  • 超高齢者における経カテーテル大動脈弁植え込み術の一症例

    前田 真岐志, 枝長 充隆, 茶木 友浩, 立花 俊祐, 吉川 裕介, 山蔭 道明

    Cardiovascular Anesthesia   20 ( Suppl. )   228 - 228   2016.9

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  • Changes in synaptic transmission of substantia gelatinosa neurons after spinal cord hemisection revealed by analysis using in vivo patch-clamp recording Reviewed

    Yuji Kozuka, Mikito Kawamata, Hidemasa Furue, Takashi Ishida, Satoshi Tanaka, Akiyoshi Namiki, Michiaki Yamakage

    MOLECULAR PAIN   12   2016.8

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    DOI: 10.1177/1744806916665827

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  • 経皮的心肺補助下に緊急気管切開術を施行した甲状腺腫瘍の1症例

    横山 竜也, 新山 幸俊, 吉川 裕介, 高田 幸昌, 高橋 和伸, 君島 和彦, 山蔭 道明

    麻酔科学サマーセミナー   13回   40 - 40   2016.6

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  • シバリングを契機に発症したと考えられる術後悪性高熱症の1症例

    汲田 翔, 立花 俊祐, 早瀬 知, 新谷 知久, 山蔭 道明

    臨床麻酔   40 ( 4 )   583 - 586   2016.4

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  • [A Patient with Klippel-Feil Syndrome Having Difficulties in Inserting and Placing an Endotracheal Tube under General Anesthesia].

    Yusuke Hashidume, Shunsuke Tachibana, Yukimasa Takada, Mitsutaka Edanaga, Michiaki Yamakage

    Masui. The Japanese journal of anesthesiology   65 ( 4 )   373 - 6   2016.4

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    A patient with Klippel-Feil syndrome had difficulties in inserting and placing an endotracheal tube under general anesthesia. Klippel-Feil syndrome, characterized by cervical vertebral fusion, scoliosis and endocardiosis, is a rare disease. Anesthesiologists should pay attention to management of anesthesia in airway troubles. A 53-year-old woman diagnosed with Klippel-Feil syndrome was scheduled for general anesthesia with intubation. We tried to insert an endotracheal tube using McGRATH MAC, but it was difficult to insert and place the tube. Finally, we managed to insert a 5.5 mm endotracheal tube. The three-dimensional computed tomography (3D-CT) images after the operation, showed tracheal stenosis at the level of the fourth and fifth cervical vertebrae. In cases where airway difficulties are expected, evaluating 3D-CT images might be useful in airway management.

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  • 術前検査の項目について

    大瀧 千代, 新山 幸俊, 山蔭 道明

    臨床麻酔   40 ( 3 )   521 - 523   2016.3

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  • Quadratus Lumborum Block Analgesic Effects and Chronological Ropivacaine Concentrations After Laparoscopic Surgery Reviewed

    Takeshi Murouchi, Soshi Iwasaki, Michiaki Yamakage

    REGIONAL ANESTHESIA AND PAIN MEDICINE   41 ( 2 )   146 - 150   2016.3

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    DOI: 10.1097/AAP.0000000000000349

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  • Severity of Myasthenia Gravis Influences the Relationship between Train-of-four Ratio and Twitch Tension and Run-down of Rat Endplate Potentials Reviewed

    Kazunobu Takahashi, Tomohisa Niiya, Yukimasa Takada, Eichi Narimatsu, Michiaki Yamakage

    ANESTHESIOLOGY   124 ( 2 )   369 - 377   2016.2

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    DOI: 10.1097/ALN.0000000000000949

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  • Nitrite Reduces Ischemia-Induced Ventricular Arrhythmias by Attenuating Connexin 43 Dephosphorylation in Rats. International journal

    Daisuke Maruyama, Naoyuki Hirata, Yasuyuki Tokinaga, Ryoichi Kawaguchi, Michiaki Yamakage

    Anesthesia and analgesia   122 ( 2 )   410 - 7   2016.2

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    BACKGROUND: Ventricular arrhythmias induced by ischemic heart disease are the main cause of sudden cardiac death. Ischemia can cause life-threatening arrhythmias by modulating connexin 43 (Cx43), a principal cardiac gap junction channel protein. The present study investigates whether nitrite can attenuate ischemia-induced ventricular arrhythmias and dephosphorylation of Cx43 in a rat model. METHODS: Rats were medicated with normal saline (control, n = 10), nitrite (0.015, 0.15, and 1.5 mg/kg, n = 9 or 10 each), and 0.15 mg/kg nitrite with either the nitric oxide scavenger 2-(4-carboxyphenyl)-4, 4, 5, 5-tetramethylimidazoline-1-oxyl-3-oxide, sodium salt (cPTIO; n = 9) or allopurinol (xanthine oxidoreductase inhibitor, n = 9). We determined the severity of ventricular arrhythmias based on arrhythmia scores and levels of phosphorylated Cx43. RESULTS: The median arrhythmia score may have been lower in the group given 0.15 mg/kg nitrite (4 [interquartile range {IQR}, 4-5]) than that in the control group (7.5 [IQR, 5.25-8]; P = 0.013). There was no difference among the control, the given 0.015 mg/kg nitrite (7 [IQR, 5-8]), and 1.5 mg/kg nitrite (7 [IQR, 5.5-7.75]; P = 0.95). The arrhythmia scores in the cPTIO (6 [IQR, 5-8]; P = 0.030) and allopurinol (7 [IQR, 5-8]; P = 0.005) groups may have been higher than that in 0.15 mg/kg nitrite group. Immunoblotting revealed that the level of phosphorylated Cx43 in the group given 0.15 mg/kg nitrite, but not in the other treated groups, was significantly higher compared with the control group (P = 0.007). CONCLUSIONS: Nitrite may have attenuated acute ischemia-induced ventricular arrhythmias and Cx43 dephosphorylation in rats. Nitric oxide, which might be generated by xanthine oxidoreductase via nitrite reduction, appears to play a crucial role in this antiarrhythmic effect.

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  • 敗血症性心機能障害に対する亜硝酸塩の保護作用

    川口 亮一, 平田 直之, 井上 茂亮, 渡邊 伸央, 吉川 裕介, 茶木 友浩, 宮下 龍, 山蔭 道明

    日本集中治療医学会雑誌   23 ( Suppl. )   429 - 429   2016.1

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  • Efficacy and Safety of a Lidocaine and Ropivacaine Mixture for Scalp Nerve Block and Local Infiltration Anesthesia in Patients Undergoing Awake Craniotomy. International journal

    Tomohiro Chaki, Shigekazu Sugino, Piotr K Janicki, Yoshiya Ishioka, Yosuke Hatakeyama, Tomo Hayase, Miki Kaneuchi-Yamashita, Naonori Kohri, Michiaki Yamakage

    Journal of neurosurgical anesthesiology   28 ( 1 )   1 - 5   2016.1

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    BACKGROUND: Mixtures of various local anesthetics, such as lidocaine and ropivacaine, have been widely used. However, their efficacy and safety for scalp nerve blocks and local infiltration during awake craniotomy have not been fully elucidated. METHODS: We prospectively investigated 53 patients who underwent awake craniotomy. Scalp block was performed for the blockade of the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves with a mixture containing equal volumes of 2% lidocaine and 0.75% ropivacaine, including 5 μg/mL of epinephrine. Infiltration anesthesia was applied at the site of skin incision using the same mixture. The study outcomes included changes in heart rate and blood pressure after head pinning and skin incision, and incidence of severe pain on emergence from anesthesia. Total doses and plasma concentrations of lidocaine and ropivacaine were measured at different time points after performing the block. RESULTS: The heart rate and blood pressure after head pinning were marginally, but significantly, increased when compared with baseline values. There were no significant differences in heart rate and blood pressure before and after the skin incision. Nineteen percent of the patients (10/53) complained of incisional pain at emergence from anesthesia. The highest observed blood concentrations of lidocaine and ropivacaine were 1.9±0.9 and 1.1±0.4 μg/mL, respectively. No acute anesthetic toxicity symptom was observed. CONCLUSIONS: Scalp block with a mixture of lidocaine and ropivacaine seems to provide effective and safe anesthetic management in patients undergoing awake craniotomy.

    DOI: 10.1097/ANA.0000000000000149

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  • Reply to: performance of the Eleveld pharmacokinetic model to titrate propofol in an obese Japanese patient population. International journal

    Nobuko Tachibana, Yukitoshi Niiyama, Michiaki Yamakage

    European journal of anaesthesiology   33 ( 1 )   59 - 60   2016.1

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  • McGRATH® MAC is useful to learn tracheal intubation using a macintosh laryngoscope

    Keiko Wakasugi, Yukitoshi Niiyama, Asuka Kita, Hajime Sonoda, Michiaki Yamakage

    Japanese Journal of Anesthesiology   64 ( 10 )   1091 - 1096   2015.10

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  • TACR1 gene polymorphism and sex differences in postoperative nausea and vomiting Reviewed

    T. Hayase, S. Sugino, H. Moriya, M. Yamakage

    ANAESTHESIA   70 ( 10 )   1148 - 1159   2015.10

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    DOI: 10.1111/anae.13082

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  • デクスメデトミジンは高血圧性肥大心筋においても直接心筋保護作用を保持する

    吉川 裕介, 平田 直之, 川口 亮一, 宮下 龍, 丸山 大介, 茶木 友浩, 山蔭 道明

    Cardiovascular Anesthesia   19 ( Suppl. )   218 - 218   2015.10

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  • Chronological Changes in Ropivacaine Concentration and Analgesic Effects between Transversus Abdominis Plane Block and Rectus Sheath Block

    Takeshi Murouchi, Soshi Iwasaki, Michiaki Yamakage

    Regional Anesthesia and Pain Medicine   40 ( 5 )   568 - 571   2015.9

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    DOI: 10.1097/AAP.0000000000000288

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  • Movements of the double-lumen endotracheal tube due to lateral position with head rotation and tube fixation: a Thiel-embalmed cadaver study Reviewed

    Daisuke Maruyama, Tomohiro Chaki, Masahito Omote, Naoyuki Hirata, Masanori Yamauchi, Michiaki Yamakage

    SURGICAL AND RADIOLOGIC ANATOMY   37 ( 7 )   841 - 844   2015.9

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    DOI: 10.1007/s00276-014-1411-6

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  • 超低出生体重児の動脈管結紮術2例の経験を通した術中体温管理の重要性

    大野 翔, 立花 俊祐, 枝長 充隆, 茶木 友浩, 吉川 裕介, 山蔭 道明

    日本小児麻酔学会誌   21 ( 1 )   140 - 140   2015.8

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  • Recovery of postoperative cognitive function in elderly patients after a long duration of desflurane anesthesia: a pilot study Reviewed

    Shunsuke Tachibana, Tomo Hayase, Michiko Osuda, Satoshi Kazuma, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   29 ( 4 )   627 - 630   2015.8

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    DOI: 10.1007/s00540-015-1979-y

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  • 小児におけるi-gelのリーク圧の継時的変化

    吉川 裕介, 平田 直之, 名和 由布子, 宮下 龍, 茶木 友浩, 山蔭 道明

    日本小児麻酔学会誌   21 ( 1 )   152 - 152   2015.8

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  • Serum antimicrobial concentrations for surgical antimicrobial prophylaxis in radical nephrectomy and radical prostatectomy. International journal

    Satoshi Takahashi, Koji Ichihara, Kohei Hashimoto, Yoshiki Hiyama, Takashi Muranaka, Jiro Hashimoto, Fumimasa Fukuta, Ko Kobayashi, Yukitoshi Niiyama, Michiaki Yamakage, Naoya Masumori

    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy   21 ( 6 )   464 - 7   2015.6

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    To evaluate the current methods of surgical antimicrobial prophylaxis from the viewpoint of pharmacokinetics for patients undergo urologic surgery, this study was designed to measure the serum concentrations of two different prophylactic antimicrobial agents in different types of urologic surgery. This prospective study included 39 patients with prostate cancer, renal pelvic cancer, ureteral cancer or renal cancer treated by radical surgery from August 2005 to March 2006. Blood samples were taken intraoperatively at 30 min and 180 min after the beginning of the first administration. The half-life of the beta phase of cefazolin is 2.46 h and that of piperacillin is 0.7 h according to their manufacturers. The average serum concentration of cefazolin at 30 min was 144 μg/mL in the prostatectomy group and 175 μg/mL in the nephrectomy group. At 180 min, the average concentration of cefazolin was 37 μg/mL in prostatectomy group and 59 μg/mL in the nephrectomy group. The average concentration of piperacillin at 30 min was 134 μg/mL in the prostatectomy group and 137 μg/mL in the nephrectomy group. At 180 min, the average concentration of piperacillin was 10 μg/mL in the prostatectomy group and 22 μg/mL in the nephrectomy group. Thus, the concentration at 180 min after the beginning of infusion was different according to the half-life of each antimicrobial agent. Therefore, up-to-date guidelines for surgical antimicrobial prophylaxis that deal with additional types of intraoperative prophylaxis should be consulted if the operation exceeds two half-lives of the prophylactic antimicrobial agents used in real-life clinical practice.

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  • Incidence of cannot intubate-cannot ventilate (CICV): results of a 3-year retrospective multicenter clinical study in a network of university hospitals Reviewed

    Nobuko Tachibana, Yukitoshi Niiyama, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   29 ( 3 )   326 - 330   2015.6

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    DOI: 10.1007/s00540-014-1847-1

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  • 深部温測定装置SpotOn(スポットオン)の有用性

    立花 俊祐, 平田 直之, 酒井 渉, 山蔭 道明

    臨床麻酔   39 ( 6 )   917 - 920   2015.6

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  • Ultrasound analysis of the anatomical relationships between vertebral arteries and internal jugular veins in adults

    Ayumi Uno, Satoru Tanaka, Makoto Kanno, Yoshiya Ishioka, Masanori Watanabe, Michiaki Yamakage

    Japanese Journal of Anesthesiology   64 ( 4 )   383 - 387   2015.4

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  • [Successful Management of Cardiopulmonary Bypass Using Heparin in a Patient with Previous History of Heparin-induced Thrombocytopenia].

    Makoto Kanno, Mitsutaka Edanaga, Naomi Mizukami, Yasuyuki Tokinaga, Yukitoshi Niiyama, Michiaki Yamakage

    Masui. The Japanese journal of anesthesiology   64 ( 4 )   449 - 52   2015.4

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    Anti-coagulant management of cardiopulmonary bypass for the patient complicated with heparin-induced thrombocytopenia (HIT) is difficult. A woman of late 50's with a previous history of HIT was scheduled for mitral valve replacement, tricuspid valvuloplasty and coronary artery bypass graft. We knew that heparin antibody was negative by serologic and functional assay before the operation. According to the HIT guideline, we planned to use heparin only during cardiopulmonary bypass and to use argatroban for other catheters. Although the platelet count continued decreasing up to the 5th postoperative day unless the transfusion of platelets, heparin antibody was negative on the first postoperative day. But, it was thought that HIT would develop from 5 days to 10 days after using heparin. Therefore, we had to examine heparin antibody on the 5th postoperative day at least for the patients with a history of HIT. In the future, it is important to observe the patient carefully and examine heparin antibody.

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  • Predictors of hypofibrinogenemia in blunt trauma patients on admission Reviewed

    Yoshinobu Kimura, Saori Kimura, Shinzou Sumita, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   29 ( 2 )   242 - 248   2015.4

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  • Craniotomy in a pediatric patient complicated with insufficiently controlled diabetes mellitus: Intraoperative management with remifentanil and an electrolyte-containing glucose solution

    Maiko Homma, Soshi Iwasaki, Fumiyuki Sugime, Takeshi Murouchi, Michiaki Yamakage

    Japanese Journal of Anesthesiology   64 ( 1 )   87 - 91   2015.1

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  • Use of a New Monitoring Device for Measuring Respiration Rate

    EDANAGA Mitsutaka, TAKADA Yukimasa, YAMAKAGE Michiaki

    JJSCA   35 ( 2 )   250 - 256   2015

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    In our questionnaire regarding the definition of respiratory depression (RD), there was little difference between the answers from anesthesiologists and nurses. When narcotic anesthetics are used for postoperative analgesia, we have to consider RD, that is, bradypnea. Previous reports suggested that the onset of bradypnea due to narcotic anesthetics might be faster than that of hypoxia. A noninvasive respiratory monitoring device using an adhesive sensor with an integrated acoustic transducer (RRa) positioned on the patient's throat (Rad-87 Pulse CO-Oximeter, Masimo Japan Co., Tokyo, Japan) has recently become available. We studied the accuracy of acoustic monitoring during general anesthesia in adult patients (>30 kg) and pediatric patients (<30 kg) using this device. Respiration rate determined by the acoustic monitor correlated well with that determined by a capnometer during general anesthesia in both adult and pediatric patients. Our study as well as previous studies suggests that using this reliable respiration rate monitor in an in-hospital setting might be essential for security and risk management.

    Other Link: http://search.jamas.or.jp/link/ui/2015205266

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  • Evaluation of bias in predicted and measured propofol concentrations during target-controlled infusions in obese Japanese patients: an open-label comparative study. International journal

    Nobuko Tachibana, Yukitoshi Niiyama, Michiaki Yamakage

    European journal of anaesthesiology   31 ( 12 )   701 - 7   2014.12

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    BACKGROUND: Target-controlled infusions (TCIs) of propofol are commonly used for general anaesthesia. The Marsh model pharmacokinetic parameter set incorporated in TCI devices for propofol could increase bias when used in obese patients. OBJECTIVE: The purpose of this study was to assess the optimal predicted blood concentration (Cp) of 4.0 μg ml of propofol using a correction formula including BMI and to evaluate the influences on propofol concentration in obese patients. DESIGN: An open-label, comparative study. SETTING: Sapporo Medical University Hospital, Japan, from October 2011 to December 2013. PATIENTS: Seventy-five adults scheduled for elective surgery under general anaesthesia with the following exclusion criteria: less than 30 or more than 65 years of age; American Society of Anesthesiologists status 3 to 5; allergy to propofol; the daily use of psychoactive drugs; known or suspected drug or alcohol abuse; and cardiac, hepatic, renal or neurological impairment. INTERVENTION: Propofol was administered and maintained at a Cp of 4.0 μg ml using a TCI device programmed with the Marsh pharmacokinetic model. Arterial blood samples were collected at 15, 30, 60, 90, 120, 150 and 180 min after the start of the infusion, and the measured propofol concentration (Cm) was determined. After calculation of the adjustment formula using the corrected Cp of 69 patients, we then applied the corrected Cp to five other obese patients. MAIN OUTCOME MEASURES: The median performance error (MDPE) and median absolute performance error (MDAPE) were calculated to measure bias at each time point. RESULTS: We analysed 333 samples from the 69 individuals. There was a significant correlation between BMI and Cm, which tended be greater than 4.0 μg ml in obese patients. Our new method improved MDPE and MDAPE from a range of 20 to 40 for both, to ranges of -11.3 to -1.8 and 8.8 to 11.5, respectively. CONCLUSION: BMI influences blood propofol concentrations, leading to the possibility of overdosage of propofol in obese patients when the Marsh model is used to assess propofol concentration. Our new method using corrected Cp might improve this bias in obese, Japanese patients.

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  • Anesthetic management for nasal foreign body removal in children

    Takuya Tonozaki, Kohki Nishikawa, Shigeo Tsuchiya, Yuki Shimodate, Michiaki Yamakage

    Japanese Journal of Anesthesiology   63 ( 11 )   1254 - 1256   2014.11

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  • Effects of local infiltration analgesia for posterior knee pain after total knee arthroplasty: comparison with sciatic nerve block Reviewed

    Eri Gi, Masanori Yamauchi, Michiaki Yamakage, Chiharu Kikuchi, Hitoshi Shimizu, Yohei Okada, Shuji Kawamura, Tomoyuki Suzuki

    JOURNAL OF ANESTHESIA   28 ( 5 )   696 - 701   2014.10

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    DOI: 10.1007/s00540-014-1793-y

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  • Suppression of bone marrow-derived microglia in the amygdala improves anxiety-like behavior induced by chronic partial sciatic nerve ligation in mice. International journal

    Atsushi Sawada, Yukitoshi Niiyama, Koji Ataka, Kanna Nagaishi, Michiaki Yamakage, Mineko Fujimiya

    Pain   155 ( 9 )   1762 - 1772   2014.9

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    Chronic neuropathic pain causes abnormal sensitivities such as hyperalgesia and allodynia, and emotional abnormalities such as anxiety and depression. Although spinal cord microglia are involved in abnormal sensitivity to neuropathic pain, no previous studies have examined the mechanism of neuropathic pain-induced anxiety. Here, we examined the involvement of bone marrow (BM)-derived microglia aggregated in the amygdalae of mice with chronic neuropathic pain in the development of anxiety-like behavior. We prepared partial sciatic nerve ligations (PSNL) in mice that received bone marrow transplantation from green fluorescent protein (GFP)-Tg mice after irradiation with head protection, and examined GFP-positive microglia in the central nuclei of the amygdalae (CeA). On day 28 after PSNL, BM-derived microglia aggregated in the CeA concurrent with anxiety-like behavior. BM-derived microglia in the CeA highly expressed interleukin (IL)-1β and C-C chemokine receptor type 2 (CCR2). In addition, neurons in the CeA highly expressed monocyte chemotactic protein-1 (MCP-1), a ligand for CCR2, in PSNL-treated mice compared to sham-operated mice, suggesting that the MCP-1/CCR2 axis is involved in the recruitment of BM-derived microglia. Oral administration of a CCR2 antagonist decreased the number of BM-derived microglia in the CeA, and successfully reversed the anxiety-like behavior and hypersensitivity to mechanical stimuli in PSNL-treated mice. Microinjections of an IL-1β receptor antagonist directly into the CeA successfully reversed the anxiety-like behavior in the PSNL-treated mice even though the neuropathic pain persisted. These results suggest that the recruitment of BM-derived microglia to the CeA via the MCP-1/CCR2 axis and neuron-microglia interactions might be important in the pathogenesis of neuropathic pain-induced anxiety.

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  • デクスメデトミジンは心筋への直接作用により虚血再灌流障害による心房機能障害を軽減する

    吉川 裕介, 平田 直之, 川口 亮一, 宮下 龍, 丸山 大介, 山蔭 道明

    Cardiovascular Anesthesia   18 ( Suppl. )   274 - 274   2014.9

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  • 特発性肺高血圧症を合併した成人の部分肺静脈還流異常症修復術の麻酔経験

    西原 教晃, 川口 亮一, 吉川 裕介, 時永 泰行, 山蔭 道明

    Cardiovascular Anesthesia   18 ( Suppl. )   261 - 261   2014.9

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  • Treatment of life-threatening hypercapnia with isoflurane in an infant with status asthmaticus Reviewed

    Yoshiki Masuda, Hiroomi Tatsumi, Kyoko Goto, Hitoshi Imaizumi, Shin-ichiro Yoshida, Tomohiko Kimijima, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   28 ( 4 )   610 - 612   2014.8

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    DOI: 10.1007/s00540-013-1751-0

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  • Differential axillary nerve block for hand or forearm soft-tissue surgery Reviewed

    Natsumi Kii, Masanori Yamauchi, Kazunobu Takahashi, Michiaki Yamakage, Takuro Wada

    JOURNAL OF ANESTHESIA   28 ( 4 )   549 - 553   2014.8

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    DOI: 10.1007/s00540-013-1773-7

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  • Improved non-invasive total haemoglobin measurements after in-vivo adjustment. International journal

    R Miyashita, N Hirata, S Sugino, M Mimura, M Yamakage

    Anaesthesia   69 ( 7 )   752 - 6   2014.7

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    We hypothesised that an in-vivo adjustment method and/or a newer sensor would increase the accuracy of non-invasive and continuous haemoglobin monitoring (SpHb) measurements. Two sensors, the R1-25 and R2-25a (the newer version), were used with laboratory total haemoglobin concentration (tHb) values simultaneously recorded. In-vivo adjusted SpHb (AdHb) was calculated by a simple formula: AdHb = SpHb - (1(st) SpHb - 1(st) tHb). The correlation coefficients between SpHb (or AdHb) and tHb were compared: SpHb in both sensors correlated strongly with tHb (p < 0.0001). In-vivo adjustment improved the correlation coefficient between SpHb and tHb from 0.86 to 0.95 for the R1-25 and from 0.83 to 0.93 for the R2-25a. There was no difference between the R1-25 and R2-25a sensors. The in vivo adjustment method improved the accuracy of SpHb measurements in both sensors.

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  • Improvement of Generic Sevoflurane by a New Production Process

    Tomo Hayase, Shigekazu Sugino, Shun-suke Tachibana, Naoyuki Hirata, Michiaki Yamakage

    LETTERS IN DRUG DESIGN & DISCOVERY   11 ( 4 )   495 - 501   2014.5

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    DOI: 10.2174/1570180810666131113211447

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  • Phosphodiesterase 4 Inhibitor Roflumilast Improves the Bronchodilative Effect of Sevoflurane in Sensitized Airways Reviewed

    Jing Zhou, Sohshi Iwasaki, Michiaki Yamakage

    ANESTHESIOLOGY   120 ( 5 )   1152 - 1159   2014.5

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    DOI: 10.1097/ALN.0000000000000160

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  • ラット敗血症モデルにおける亜硝酸塩の心保護作用

    川口 亮一, 平田 直之, 宮下 龍, 丸山 大介, 吉川 裕介, 山蔭 道明

    Shock: 日本Shock学会雑誌   29 ( 1 )   48 - 48   2014.5

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  • Dealing with a broken bottle of desflurane.

    Daisuke Maruyama, Naoyuki Hirata, Michiaki Yamakage

    Journal of anesthesia   28 ( 2 )   322 - 322   2014.4

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  • Single-nucleotide polymorphisms and copy number variations of the FCGR2A and FCGR3A genes in healthy Japanese subjects. International journal

    Hiroyuki Moriya, Katsuhiko Saito, Nuala Helsby, Naomi Hayashi, Shigekazu Sugino, Michiaki Yamakage, Takeru Sawaguchi, Masahiko Takasaki, Masato Takahashi, Nahoko Kurosawa

    Biomedical reports   2 ( 2 )   265 - 269   2014.3

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    FcγRII and FcγRIII are low-affinity Fcγ receptors that are encoded by the FCGR2A and FCGR3A genes, respectively. These genes contain functional single-nucleotide polymorphisms (SNPs), which alter the binding affinities of these receptors for the γ chain of the Fc fragment of immunoglobulin G. The known SNPs in FCGR2A and FCGR3A are rs1801274 (A>G; H131R) and rs396991 (T>G; F158V), respectively. It is also known that there are copy number variations (CNVs) in the genetic locus (1q23) where FCGR2A and FCGR3A are located. However, the frequencies of these SNPs and CNVs have not been determined in the Japanese population. The aim of this study was to investigate SNPs and CNVs in FCGR2A and FCGR3A among 113 healthy individuals. The SNPs and CNVs in FCGR2A and FCGR3A were determined using the TaqMan® SNP Genotyping and the TaqMan® Copy Number assays. Our results revealed that the incidence of FCGR2A (rs1801274) genotypes were as follows: A/A, 69.9%; A/G, 29.2%; and G/G, 0.9%. The incidence of the FCGR3A (rs396991) genotypes were as follows: T/T, 56.7%; T/G, 38.9%; and G/G, 4.4%). No CNVs were detected for FCGR2A. To the best of our knowledge, this finding has not been previously reported in the Japanese population. By contrast, CNVs were observed in FCGR3A (3 subjects were found to harbour a gene deletion and 5 subjects had 3 copies of the gene). Using simple commercially available assays we were able to confirm previous findings regarding FCGR2A and FCGR3A alleles and CNVs. These assays may provide a basis for the investigation of the role of these genes in the efficacy of antibody-based drugs, such as trastuzumab and rituximab, in Japanese subjects.

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  • Efficacy of axillary nerve block in elbow arthroscopic surgery: a randomized trial Reviewed

    Takuro Wada, Masanori Yamauchi, Gosuke Oki, Tomoko Sonoda, Michiaki Yamakage, Toshihiko Yamashita

    JOURNAL OF SHOULDER AND ELBOW SURGERY   23 ( 3 )   291 - 296   2014.3

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    DOI: 10.1016/j.jse.2013.11.022

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  • Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly or Moderately Emetogenic Chemotherapy: A Randomized, Double-Blind, Placebo-Controlled Study Reviewed

    Naomi Mizukami, Masanori Yamauchi, Kazuhiko Koike, Akihiko Watanabe, Koji Ichihara, Naoya Masumori, Michiaki Yamakage

    JOURNAL OF PAIN AND SYMPTOM MANAGEMENT   47 ( 3 )   542 - 550   2014.3

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    DOI: 10.1016/j.jpainsymman.2013.05.003

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  • Association between the low-dose irinotecan regimen-induced occurrence of grade 4 neutropenia and genetic variants of UGT1A1 in patients with gynecological cancers

    Hiroyuki Moriya, Katsuhiko Saito, Nuala Helsby, Shigekazu Sugino, Michiaki Yamakage, Takeru Sawaguchi, Masahiko Takasaki, Hidenori Kato, Nahoko Kurosawa

    Oncology Letters   7 ( 6 )   2035 - 2040   2014

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    DOI: 10.3892/ol.2014.2046

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  • Tracheal Intubation through the I-gel for Emergency Cesarean Section in a Patient with Multidrug Hypersensitivity: A New Technique. International journal

    Kartika Balaji Samala, Yuri Uchiyama, Yasuyuki Tokinaga, Yukitoshi Niiyama, Soshi Iwasaki, Michiaki Yamakage

    Case reports in anesthesiology   2014   245752 - 245752   2014

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    31-year-old female with hypersensitivity to local anesthetics and neuromuscular blocking agents presented for emergency Cesarean section. We successfully performed I-gel-assisted tracheal intubation without using neuromuscular blockers. We believe this method would be helpful in selected situations.

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  • Effect of prone positioning on cannula function and impaired oxygenation during extracorporeal circulation

    Yoshiki Masuda, Hiroomi Tatsumi, Hitoshi Imaizumi, Kyoko Gotoh, Shinichiro Yoshida, Shinya Chihara, Kanako Takahashi, Michiaki Yamakage

    Journal of Artificial Organs   17 ( 1 )   106 - 109   2014

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    DOI: 10.1007/s10047-013-0742-0

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  • Unexpectedly resolved multiple mobile thrombi in a normal thoracic aorta associated with colorectal cancer and protein C deficiency

    Yusuke Yoshikawa, Yasuhiro Kamikubo, Hajime Sonoda, Michiaki Yamakage

    Journal of Cardiothoracic and Vascular Anesthesia   28 ( 3 )   714 - 717   2014

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    DOI: 10.1053/j.jvca.2012.11.006

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  • Usefulness of Flotrac/Vigileo™ combined with transesophageal echocardiography under abdominal hysterectomy for a patient complicated with moyamoya disease and hypertrophic cardiomyopathy

    Mitsutaka Edanaga, Haruko Hayashi, Michiaki Yamakage

    Anesthesia and Resuscitation   49 ( 4 )   101 - 103   2013.12

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  • [Anesthetic management in a patient with head and neck burn by asphalt].

    Nao Suzuki, Yukitoshi Niiyama, Yasuyuki Tokinaga, Michiaki Yamakage

    Masui. The Japanese journal of anesthesiology   62 ( 10 )   1250 - 2   2013.10

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    In cases of facial burns caused by molten asphalt, examination for possible airway burns and early removal of the asphalt should be carried out to prevent chemical-induced tissue damage and infection. However, asphalt that has adhered to tissues is difficult to remove. A 35-year-old male with burns caused by molten asphalt was scheduled for emergency debridement. He had 6% body surface area burns on his face and neck. He was not able to open his eyes due to the adherence of asphalt. His respiratory condition was stable and a perioperative fiberoptic view revealed no airway burns. After awake intubation, orange peel oil was used to remove the asphalt from his face and eyes. Since orange peel oil does not contain any harmful substances, it is effective for removing asphalt without causing tissue damage.

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  • 脂肪乳剤が心筋虚血再灌流障害へ及ぼす影響

    平田 直之, 宮下 龍, 丸山 大介, 川口 亮一, 吉川 裕介, 山蔭 道明

    蘇生   32 ( 3 )   200 - 200   2013.10

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  • Fabry病患者に対する脊椎手術の麻酔経験

    君島 知彦, 辻口 直紀, 立花 俊祐, 君塚 基修, 山蔭 道明

    日本臨床麻酔学会誌   33 ( 6 )   S319 - S319   2013.10

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  • 気道確保にMcGRATHが有用であったBlue rubber bleb nevus syndromeの1症例

    数馬 聡, 杉野 繁一, 早瀬 知, 水口 亜紀, 山蔭 道明

    日本臨床麻酔学会誌   33 ( 6 )   S251 - S251   2013.10

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  • Regional anesthesia for a pregnant patient with symptomatic hypothyroidism

    Yoshiki Masuda, Shinichiro Yoshida, Hitoshi Imaizumi, Michiaki Yamakage

    Anesthesia and Resuscitation   49 ( 3 )   81 - 83   2013.9

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  • 小児先天性心疾患手術において術中麻酔薬投与量が術後人工呼吸時間に与える影響

    吉川 裕介, 名和 由布子, 平田 直之, 山蔭 道明

    Cardiovascular Anesthesia   17 ( Suppl. )   165 - 165   2013.9

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  • A prospective randomized multicenter comparative study of BLM-240 (desflurane) versus sevoflurane in Japanese patients Reviewed

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

    Journal of Anesthesia   27 ( 3 )   468 - 471   2013.6

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    DOI: 10.1007/s00540-012-1536-x

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  • Effects of storage temperature of the blood on erythrocyte metabolism and platelet function

    Shinichiro Yoshida, Yoshiki Masuda, Hitoshi Imaizumi, Tomohiko Kimijima, Kyoko Goto, Ryoko Kyan, Hiroomi Tatsumi, Michiaki Yamakage

    Anesthesia and Resuscitation   49 ( 2 )   53 - 55   2013.6

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  • 非侵襲的全ヘモグロビン濃度測定が有効であった脳死下臓器提供の1症例

    田辺 美幸, 杉野 繁一, 宮下 龍, 君島 知彦, 成松 英智, 山蔭 道明

    麻酔   62 ( 6 )   699 - 701   2013.6

  • [Anesthetic management of organ donation after brain death using continuous total hemoglobin measurement].

    Miyuki Tanabe, Shigekazu Sugino, Ryo Miyashita, Tomohiko Kimijima, Eichi Narimatsu, Michiaki Yamakage

    Masui. The Japanese journal of anesthesiology   62 ( 6 )   699 - 701   2013.6

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    A 60-year-old woman declared brain dead was scheduled for organ donation. We continuously measured total hemoglobin values (SpHb) using a Radical-7 monitor (Masimo Co, Irvine, CA, USA) to maintain the functions of organs and oxygen delivery. At the start of surgery, the SpHb value was 9.3 g x dl(-1). Packed red blood cells were transfused immediately No anesthetics or opioids were used during the operation. Blood pressure suddenly decreased to below 80 mmHg because of bleeding, manipulation of organs, and/or compression of the vena cava. Six units of red blood cells and 900 ml of colloids were rapidly transfused with real-time monitoring of SpHb values. On cross-clamping of the aorta, the SpHb value increased up to 10.2 g x dl(-1). The heart, lungs, liver, pancreas, and kidneys were donated from the patient without organ dysfunction. The highlight of this case report is that anesthesiologists could use SpHb monitoring for management of hemodynamics in a brain-dead organ donor.

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  • Three cases of ATP-induced bronchospasm during thoracic endovascular aortic repair Reviewed

    Yukimasa Takada, Toshiya Kawagishi, Natsumi Kii, Misako Higuchi, Masanori Yamauchi, Michiaki Yamakage

    Japanese Journal of Anesthesiology   62 ( 4 )   402 - 405   2013.4

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  • [Introduction of translational research in omics science to clinical anesthesia].

    Shigekazu Sugino, Tomo Hayase, Michiaki Yamakage

    Masui. The Japanese journal of anesthesiology   62 ( 3 )   296 - 303   2013.3

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    Much progress has been made in omics research following completion of the Human Genome Project. This comprehensive analysis produced a new discipline (i.e., bioinformatics), and its findings contributed to the clinical practice of anesthesiology. Genomes of patients show genetic variations and may predict the sensitivity to anesthetics and analgesics, incidence of adverse effects, and intensity of postsurgical pain. Changes in the transcriptomes of patients may also reflect anesthesia-related expression profiles of various types of neurons in the brain, and information on such changes may contribute to molecular targeted therapy in anesthetized patients. In addition, novel epigenome research may explain why environments change the phenotypes of clinical anesthesia. We currently hypothesize that female gender is associated with DNA methylation in pain-related and vomiting-related gene promoter regions at the genome-wide level and that epigenetic mechanisms are involved in gender differences in anesthesia practice.

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  • 【麻酔科学領域の基礎研究の臨床応用】麻酔科学へのオミクス研究の導入と臨床麻酔での可能性

    杉野 繁一, 早瀬 知, 山蔭 道明

    麻酔   62 ( 3 )   296 - 303   2013.3

  • [Anesthetic management of a patient with metatropic dysplasia].

    Marie Suzuki, Yukitoshi Niiyama, Yuko Nawa, Michiaki Yamakage

    Masui. The Japanese journal of anesthesiology   62 ( 2 )   220 - 2   2013.2

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    A 5-year-old girl with metatropic dysplasia was scheduled for an operation of posterior cervical fusion. This disease is a rare skeletal dysplasia characterized by long trunk and short limbs and severe scoliosis. As she had been suspected to have a difficult airway, we attempted fiberoptic intubation with a nasopharyngeal airway to prevent airway obstruction. The nasopharyngeal airway ensured a patent airway sufficient oxygenation, and anesthesia. Thus, it was possible to perform a fiberoptic intubation via the opposite nostril with no adverse event. The combination of a nasopharyngeal airway and fiberoptic guided tracheal intubation is a reliable and safe procedure for small children with metatropic dysplasia and difficult airway.

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  • Blockers of adenosine A1, but not muscarinic acetylcholine, receptors improve excessive extracellular glutamate-induced synaptic depression Reviewed

    Eichi Narimatsu, Tomohisa Niiya, Yukimasa Takada, Kazunobu Takahashi, Masanori Yamauchi, Michiaki Yamakage

    Neuroscience Research   75 ( 2 )   103 - 111   2013.2

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    DOI: 10.1016/j.neures.2012.11.002

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  • Ultrasound-guided subcostal and mid-axillary transversus abdominis plane block: A cadaveric study of the spread of injectate Reviewed

    Takeshi Murouchi, Masanori Yamauchi, Eri Gi, Yukimasa Takada, Aki Mizuguchi, Michiaki Yamakage, Mineko Fujimiya

    Japanese Journal of Anesthesiology   62 ( 1 )   60 - 63   2013.1

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  • The association between heterozygosity for UGT1A1*6, UGT1A1*28, and variation in the serum total-bilirubin level in healthy young Japanese adults

    Hiroyuki Moriya, Katsuhiko Saito, Nuala Helsby, Shigekazu Sugino, Michiaki Yamakage, Masahiko Takasaki, Hidenori Kato, Nahoko Kurosawa

    Genetic Testing and Molecular Biomarkers   17 ( 6 )   464 - 469   2013

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    DOI: 10.1089/gtmb.2012.0402

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  • Substrate-dependent modulation of oxidative phosphorylation in isolated mitochondria following in vitro hypoxia and reoxygenation injury. International journal

    Daisuke Maruyama, Naoyuki Hirata, Ryo Miyashita, Ryoichi Kawaguchi, Michiaki Yamakage

    Experimental and clinical cardiology   18 ( 2 )   158 - 60   2013

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    BACKGROUND/OBJECTIVES: Previous studies using isolated mitochondria have provided new insight into the mechanisms and interventions for ischemia and reperfusion (I/R) injury. In in vitro experiments involving isolated mitochondria, hypoxia and reoxygenation (H/R) has been widely used to mimic I/R injury. However, in in vitro H/R mitochondrial experiments, the effects of various substrates on mitochondrial oxidative phosphorylation are unclear. In the present study, the effects of in vitro I/R injury on mitochondrial oxidative phosphorylation under different substrate conditions were investigated. METHODS: Hypoxia was achieved following complete consumption of oxygen by mitochondria isolated from rat heart tissue in an experimental chamber. The H/R protocol involved 30 min hypoxia followed by 15 min reoxygenation in a chamber opened to the atmosphere. Mitochondrial respiration and respiratory control ratio (RCR) were measured. RESULTS: When pyruvate/malate were used as substrates, H/R significantly decreased state 3 respiration (28.2±12 nmol O2/min/mg protein) and RCR (2.7±0.8) compared with the control (121.4±32.5 nmol O2/mg protein/min and 7.8±1.2, respectively). In contrast, when succinate was used without rotenone, H/R significantly increased state 3 respiration (57.0±11.2 nmol O2/mg protein/min) and RCR (2.0±0.3) compared with the control (48.2±12.3 nmol O2/mg protein/min and 1.3±0.2, respectively). CONCLUSIONS: The present study demonstrated that mitochondrial oxidative phosphorylation can be modulated by H/R in vitro depending on substrate conditions.

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  • Heart rate variability during abdominal surgical manipulation under general and epidural anesthesia Reviewed

    Naoyuki Hirata, Ryo Miyashita, Daisuke Maruyama, Ryoichi Kawaguchi, Hitoshi Shimizu, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   26 ( 6 )   900 - 904   2012.12

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    DOI: 10.1007/s00540-012-1431-5

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  • プレガバリン内服治療中のふらつきから小脳腫瘍が発見された1症例

    並木 正伸, 山内 正憲, 山蔭 道明

    The journal of the Japan Society of Pain Clinicians = 日本ペインクリニック学会誌   19 ( 4 )   546 - 547   2012.10

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    Other Link: http://search.jamas.or.jp/link/ui/2013162166

    DOI: 10.11321/jjspc.12-0016

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  • Ultrasound-guided supraclavicular central venous catheterization in patients with malignant hematologic diseases Reviewed

    Masanori Yamauchi, Hideaki Sasaki, Tsukasa Yoshida, Tomohisa Niiya, Eri Mizuno, Eichi Narimatsu, Michiaki Yamakage

    Journal of Anesthesia   26 ( 5 )   775 - 778   2012.10

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    DOI: 10.1007/s00540-012-1401-y

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  • Acute cervical spinal cord injury

    Mitsunori Yoshimoto, Toshihiko Yamashita, Soshi Iwasaki, Michiaki Yamakage

    Japanese Journal of Anesthesiology   61 ( 9 )   953 - 960   2012.9

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  • Anesthetic management in a patient with spinal progressive muscle atrophy and with compromised severe restrictive respiratory dysfunction Reviewed

    Ayumi Uno, Yukitoshi Niiyama, Nobuko Tachibana, Masanori Yamauchi, Akihiko Watanabe, Michiaki Yamakage

    Japanese Journal of Anesthesiology   61 ( 8 )   830 - 833   2012.8

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  • Pralidoxime inhibits paraoxon-induced depression of rocuronium- neuromuscular block in a time-dependent fashion Reviewed

    Eichi Narimatsu, Tomohisa Niiya, Kazunobu Takahashi, Masanori Yamauchi, Michiaki Yamakage

    American Journal of Emergency Medicine   30 ( 6 )   901 - 907   2012.7

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    DOI: 10.1016/j.ajem.2011.06.013

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  • Prediction of skin-epidural space distance by various imaging modalities

    YAMAUCHI Masanori, NIIYA Tomohisa, OHNUMA Sunao, MIZUGUCHI Aki, WATANABE Akihiko, YAMAKAGE Michiaki

    JJSPC   19 ( 2 )   81 - 85   2012.6

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    We compared the utility of predicting the skin-epidural space distance by using various imaging modalities. Subjects comprised patients meeting the indications for lumbar epidural block who had undergone magnetic resonance imaging, radiography and computed tomography for primary disease. Skin-epidural space distances from these modalities were estimated using computed calculating functions of the imaging system. Immediately after the use of ultrasonography to estimate the distance between the skin and dura mater in short-axis and longitudinal views in the lateral position, epidural puncture was performed using a median approach. Puncture distance between the skin and epidural space was recorded. Skin-epidural space distance as estimated by each modality correlated significantly with puncture distance (p<0.001), body weight (p<0.01) and body mass index (p<0.001). In particular, ultrasound imaging showed the highest correlation to puncture distance (r=0.96, p<0.001). In conclusion, ultrasound imaging can predict skin-epidural distance with high correlation to the actual puncture distance, and it could allow adequate and safe epidural block.

    Other Link: https://jlc.jst.go.jp/DN/JALC/10005810054?from=CiNii

    DOI: 10.11321/jjspc.11-0009

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  • A successfully treated case of severe sepsis after chemotherapy for malignant lymphoma due to rapid and early initiation of treatment

    Kanako Takahashi, Yoshiki Masuda, Hitoshi Imaizumi, Hiroomi Tatsumi, Kyoko Goto, Tomohiko Kimijima, Shinichiro Yoshida, Ryoko Kyan, Hiroshi Yasui, Hiroshi Ikeda, Toshiaki Hayashi, Tadao Ishida, Michiaki Yamakage

    Anesthesia and Resuscitation   48 ( 2 )   33 - 36   2012.6

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  • Myocardial infarction was first suspected in a surgical patient, but definitive diagnosis was left bundle branch block

    Tomohiro Chaki, Mitsutaka Edanaga, Miyuki Tanabe, Michiaki Yamakage

    Anesthesia and Resuscitation   48 ( 2 )   37 - 39   2012.6

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  • Genetic differences in response properties of rostral ventromedial medulla neurons to the μ-opioid receptor agonist DAMGO in mouse inbred strains. International journal

    Shigekazu Sugino, Akiyoshi Namiki, Michiaki Yamakage

    Neuroscience letters   517 ( 2 )   107 - 12   2012.5

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    BACKGROUND: Opioid sensitivity varies among individuals. Although opioids can act partly in the rostral ventromedial medulla (RVM), which has a major role in pain perception, individual differences in the functions of the RVM in response to opioids have not been elucidated. Pain-related behavior among inbred mouse strains may reflect individual differences in sensitivity to pain. We therefore investigated the changes in action potentials of RVM neurons in response to opioid in different mouse strains. METHODS: Two inbred strains of mice (A/J and CBA/J) were used. Their behavior to noxious stimuli was measured after intracerebroventricular injection of the μ-opioid receptor agonist, DAMGO. Using an in vivo extracellular recording technique, action potentials from single RVM neurons and their functional type (ON-like, OFF-like, or NEUTRAL-like cell) were identified. Evoked responses of the RVM neurons to noxious stimuli were recorded before and after DAMGO administration. RESULTS: The behavioral study showed that the dose-dependent antinociceptive effect in the A/J strain was significantly stronger than in the CBA/J strain. The electrophysiological study showed that the number of inhibitory OFF-like cells in A/J mice was significantly larger than in CBA/J mice (P<0.01), and that the evoked responses of neurons of A/J mice were inhibited significantly more than in CBA/J mice both for ON-like and OFF-like cells (P<0.01). CONCLUSIONS: The strain differences in the physiological properties of RVM neurons corresponded to the behavioral strain differences. Genetic differences may contribute to the interindividual variation seen in opioid-induced analgesia.

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  • 1%ブドウ糖加酢酸リンゲル液は手術中の脂肪・タンパク異化を抑制する

    澤田 敦史, 吉川 裕介, 山内 正憲, 渡辺 昭彦, 山蔭 道明

    麻酔   61 ( 4 )   358 - 363   2012.4

  • Utility of longitudinal paramedian view of ultrasound imaging for middle thoracic epidural anesthesia in children Reviewed

    Nobuko Tachibana, Shigekazu Sugino, Michiaki Yamakage, Masanori Yamauchi, Akihiko Watanabe

    Journal of Anesthesia   26 ( 2 )   242 - 245   2012.4

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  • Satisfaction survey of pain management for severe mucositis caused by cancer therapy for head and neck cancer

    Mizukami Naomi, Yamauchi Masanori, Watanabe Akihiko, Danzuka Keiko, Satoh Akemi, Oomori Katsuya, Nakata Hideo, Koike Kazuhiko, Yamakage Michiaki

    Palliat Care Res   7 ( 2 )   408 - 414   2012

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    <b>Purpose</b>: Head and neck cancer patients receiving chemoradiation therapy often suffer from severe mucositis. Chemoradiation therapy-induced mucositis is usually accompanied by severe and intractable pain that impairs quality of life. To establish an effective method for treatment of mucositis pain, we retrospectively investigated the relationships of radiation dose with severity of mucositis and opioid consumption. We also conducted a survey on satisfaction of pain treatment. <b>Methods</b>: Study 1: Fourteen patients who underwent chemoradiation therapy of 70 Gy for head and neck cancer from 2005 to 2009 participated in the study. The relationship of severity of mucositis with opioid use was studied. Study 2: Seven patients who had mucositis of over grade 3 and had completed radiation therapy participated in the study. We carried out a questionnaire survey about satisfaction of each pain treatment. <b>Results</b>: Study 1: Increase of radiation dose significantly worsened the severity of mucositis. Opioid consumption for treating pain was significantly greater in the pharynx cancer group than in the oral cancer group. Study 2: Oral care treatment was preferred to systemic administration of analgesics including opioids. <b>Conclusions</b>: In the oral cancer group, oral care treatment was thought to be useful for pain treatment. Oral cancer patients needed less opioids than did pharynx cancer patients.

    Other Link: http://search.jamas.or.jp/link/ui/2013205703

    DOI: 10.2512/jspm.7.408

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  • 聴性誘発電位モニタリングを用いた意識下開頭手術の麻酔管理

    石岡 慶己, 杉野 繁一, 早瀬 知, 高橋 和伸, 古瀬 晋吾, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S328 - S328   2011.10

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  • 持続SpHb測定が有用であった脳死下臓器提供の1症例

    田辺 美幸, 杉野 繁一, 君島 知彦, 宮下 龍, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S428 - S428   2011.10

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  • A case of respiratory arrest and laryngeal edema resulting from glycyrrhizin-induced severe hypokalemic myopathy

    Soshi Iwasaki, Jing Zhow, Hiromichi Ichinose, Shuuji Yamamoto, Ken-Ichi Nakabayashi, Michiaki Yamakage

    Anesthesia and Resuscitation   47 ( 3 )   65 - 68   2011.9

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  • A suspected case of amniotic fluid embolism rescued by ABO-incompatible blood transfusion and operation for a massive obstetric hemorrhage

    Mitsutaka Edanaga, Ryu Azumaguchi, Michiko Ohsuda, Michiaki Yamakage

    Anesthesia and Resuscitation   47 ( 3 )   73 - 75   2011.9

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  • Synergic bronchodilator effects of a phosphodiesterase 3 inhibitor olprinone with a volatile anaesthetic sevoflurane in ovalbumin-sensitised guinea pigs

    Jing Zhou, Sohshi Iwasaki, Akihiko Watanabe, Michiaki Yamakage

    European Journal of Anaesthesiology   28 ( 7 )   519 - 524   2011.7

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    DOI: 10.1097/EJA.0b013e3283463f4a

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  • 聴性誘発電位モニタaepEXの測定値はBISと非線形に相関する

    早瀬 知, 杉野 繁一, 石岡 慶己, 山蔭 道明

    臨床モニター   22 ( Suppl. )   44 - 44   2011.4

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  • Ultrasound-aided ipsilateral-dominant epidural block for total hip arthroplasty: a randomised controlled single-blind study. International journal

    Ryo-ichi Kawaguchi, Masanori Yamauchi, Shigekazu Sugino, Michiaki Yamakage

    European journal of anaesthesiology   28 ( 2 )   137 - 40   2011.2

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    BACKGROUND AND OBJECTIVE: Lumbar epidural anaesthesia usually affects both legs. The aim was to compare the success rates of ultrasound-aided vs. classical midline epidural catheter insertion for ipsilateral-dominant blocks and analgesia in patients undergoing total hip arthroplasty. METHODS: The protocol was designed as a prospective randomised single-blind study. In the ultrasound group (n = 12), ultrasound examination was performed to determine the puncture point and direction for ipsilateral-dominant block. In the midline group (n = 12), epidural puncture was performed by the usual midline approach. Rates of successful ipsilateral-dominant block using 6 ml of lidocaine 1.5% wt vol⁻¹ (primary outcome) and effects of patient-controlled epidural analgesia using ropivacaine 0.2% wt vol⁻¹ (secondary outcomes) were evaluated. RESULTS: The rates of successful ipsilateral-dominant block were 83% in the ultrasound group and 17% in the midline group (P = 0.004). Sensory and motor functions on the non-operated side in the ultrasound group were significantly better maintained than those on the operated side and compared with those on the non-operated side in the midline group (P < 0.05). Pain scores at mobilisation, incidence of post-operative nausea and vomiting and frequency of use of supplemental analgesics were significantly lower in the ultrasound group than in the midline group (P < 0.05). CONCLUSION: The use of ultrasound significantly improves the success rate of ipsilateral epidural block compared with the standard midline approach.

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  • Efficacy of the Airtraq (R) laryngoscope with a fiberoptic bronchoscope compared with that of Airtraq (R) alone for tracheal intubation: a manikin study Reviewed

    Kohki Nishikawa, Eiko Hukuoka, Toshiya Kawagishi, Yuki Shimodate, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   25 ( 1 )   93 - 97   2011.2

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    DOI: 10.1007/s00540-010-1038-7

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  • ROLE OF SATELLITE CELL-DERIVED L-SERINE IN THE DORSAL ROOT GANGLION IN PACLITAXEL-INDUCED PAINFUL PERIPHERAL NEUROPATHY Reviewed

    T. Kiya, T. Kawamata, A. Namiki, M. Yamakage

    NEUROSCIENCE   174   190 - 199   2011.2

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    DOI: 10.1016/j.neuroscience.2010.11.046

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  • Cigarette smoking-induced airway hyperreactivity Reviewed

    Michiaki Yamakage

    JOURNAL OF ANESTHESIA   25 ( 1 )   145 - 146   2011.2

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    DOI: 10.1007/s00540-010-1061-8

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  • Effect of divided supplementation of remifentanil on seizure duration and hemodynamic responses during electroconvulsive therapy under propofol anesthesia Reviewed

    Kohki Nishikawa, Misako Higuchi, Toshiya Kawagishi, Yuki Shimodate, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   25 ( 1 )   29 - 33   2011.2

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    DOI: 10.1007/s00540-010-1049-4

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  • Young anesthesiologists, be a frontline respiratory researcher Reviewed

    Shiroh Isono, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   25 ( 1 )   144 - 144   2011.2

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    DOI: 10.1007/s00540-010-1060-9

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  • Ultrasound-Guided Cervical Nerve Root Block: Spread of Solution and Clinical Effect Reviewed

    Masanori Yamauchi, Daisuke Suzuki, Tomohisa Niiya, Hironori Honma, Nobuko Tachibana, Akihiko Watanabe, Mineko Fujimiya, Michiaki Yamakage

    PAIN MEDICINE   12 ( 8 )   1190 - 1195   2011

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    DOI: 10.1111/j.1526-4637.2011.01170.x

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  • Optimal analgesic effect of continuous supraclavicular brachial plexus block with ropivacaine after shoulder surgery Reviewed

    Tomohisa Niiya, Masanori Yamauchi, Naomi Mizukami, Yukitoshi Niiyama, Junpei Ohsone, Hironori Honma, Tomoyuki Kawamata, Michiaki Yamakage, Tomoaki Hirose

    Japanese Journal of Anesthesiology   59 ( 11 )   1385 - 1390   2010.11

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  • 超低体温循環停止を用いた胸部下行大動脈瘤手術では運動誘発電位の変化は脊髄虚血を反映しない

    君島 知彦, 宮下 龍, 杉野 繁一, 山蔭 道明

    Cardiovascular Anesthesia   14 ( Suppl. )   169 - 169   2010.10

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  • Low-dose continuous infusion of landiolol can reduce adrenergic response during tracheal intubation in elderly patients with cardiovascular disease Reviewed

    Naoyuki Hirata, Ryo Miyashita, Akihiko Watanabe, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   24 ( 5 )   786 - 788   2010.10

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    DOI: 10.1007/s00540-010-0975-5

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  • Resent pain clinic management

    Masanori Yamauchi, Michiaki Yamakage

    Hokkaido Journal of Orthopaedics and Traumatology   52 ( 1 )   20 - 24   2010.8

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  • Ultrasound-aided unilateral epidural block for single lower-extremity pain Reviewed

    Masanori Yamauchi, Ryoichi Kawaguchi, Shigekazu Sugino, Michiaki Yamakage, Eiji Honma, Akiyoshi Namiki

    Journal of Anesthesia   23 ( 4 )   605 - 608   2009.11

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    DOI: 10.1007/s00540-009-0813-9

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  • Usefulness of Endoflex endotracheal tube for oral and nasal tracheal intubations Reviewed

    Michiaki Yamakage, Mika Takahashi, Nobuko Tachibana, Kazunobu Takahashi, Akiyoshi Namiki

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   26 ( 8 )   661 - 665   2009.8

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    DOI: 10.1097/EJA.0b013e32832a0be3

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  • Desflurane but not sevoflurane can increase lung resistance via tachykinin pathways Reviewed

    J. -I. Satoh, M. Yamakage, T. Kobayashi, N. Tohse, H. Watanabe, A. Namiki

    BRITISH JOURNAL OF ANAESTHESIA   102 ( 5 )   704 - 713   2009.5

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    DOI: 10.1093/bja/aep041

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  • Performance of four carbon dioxide absorbents in experimental and clinical settings Reviewed

    M. Yamakage, K. Takahashi, M. Takahashi, J. -I Satoh, A. Namiki

    ANAESTHESIA   64 ( 3 )   287 - 292   2009.3

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    DOI: 10.1111/j.1365-2044.2008.05759.x

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  • Beta-1 selective adrenergic antagonist landiolol and esmolol can be safely used in patients with airway hyperreactivity Reviewed

    Michiaki Yamakage, Sohshi Iwasaki, Seong-Wook Jeong, Jun-Ichi Satoh, Akiyoshi Namiki

    HEART & LUNG   38 ( 1 )   48 - 55   2009.1

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    DOI: 10.1016/j.hrtlng.2008.01.002

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  • Rocuronium for Cardiac Surgery

    YAMAKAGE Michiaki, YOSHIDA Shin-Ichiro

    JJSCA   28 ( 5 )   852 - 857   2008.8

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    Cardiac/aortic surgery can dramatically change physiological parameters such as respiration, circulation, body temperature, and electrolyte level. Although the surgery <i>per se</i> is invasive, fast-track anesthesia, which could lead to benefits for patients, is needed. Rocuronium has a rapid onset, and thus it would be useful to prevent opioid-induced muscle rigidity. Because the main metabolite of rocuronium has few muscle-relaxant effects, unexpected prolonged muscle relaxation is rare after surgery. Rocuronium is, therefore, expected to be safe and useful in cardiac/aortic surgery as well as other kinds of surgery. It is needless to say that we should pay attention to the potency of rocuronium during cardiac/aortic surgery, because the potency and the metabolism of it can be changed by hypothermia, hemodilution, and electrolyte abnormalities, as well as by complicated organ failure.

    Other Link: http://search.jamas.or.jp/link/ui/2008337185

    DOI: 10.2199/jjsca.28.852

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  • Inhibitory effects of the alpha-2 adrenergic agonists clonidine and dexmedetomidine on enhanced airway tone in ovalbumin-sensitized guinea pigs Reviewed

    M. Yamakage, S. Iwasaki, J. -I. Satoh, A. Namiki

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   25 ( 1 )   67 - 71   2008.1

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    DOI: 10.1017/S0265021507002591

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  • A case of successful withdrawal from cardiopulmonary bypass by correcting plasma Mg2+ concentration

    Atsushi Sawada, Naoyuki Hirata, Michiaki Yamakage, Masanori Yamauchi, Akiyoshi Namiki

    Anesthesia and Resuscitation   43 ( 4 )   77 - 80   2007.12

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  • The usefulness of an earphone-type infrared tympanic thermometer for Intraoperative core temperature monitoring Reviewed

    Tomohiro Kiya, Michiaki Yamakage, Tomo Hayase, Jun-Ichi Satoh, Akiyoshi Namiki

    ANESTHESIA AND ANALGESIA   105 ( 6 )   1688 - 1692   2007.12

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    DOI: 10.1213/01.ane.0000289639.87836.79

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  • Analysis of the composition of 'original' and generic sevoflurane in routine use Reviewed

    M. Yamakage, N. Hirata, H. Saijo, J. -I. Satoh, A. Namiki

    BRITISH JOURNAL OF ANAESTHESIA   99 ( 6 )   819 - 823   2007.12

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    DOI: 10.1093/bja/aem296

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  • Direct inotropic effect of the beta-2 receptor agonist terbutaline on impaired diaphragmatic contractility in septic rats Reviewed

    Mitsuru Uzuki, Michiaki Yamakage, Naoyuki Fujimura, Akiyoshi Namiki

    HEART & LUNG   36 ( 2 )   140 - 147   2007.3

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  • Anesthetic practice in Japan: past, present, and future Reviewed

    Michiaki Yamakage, Akiyoshi Namiki

    JOURNAL OF ANESTHESIA   21 ( 3 )   390 - 395   2007

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    DOI: 10.1007/s00540-007-0532-z

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  • Different inhibitory effects of sevoflurane on hyperreactive airway smooth musck contractility in ovalbumin-sensitized and chronic cigarette-smoking guinea pig models Reviewed

    Soshi Iwasaki, Michiaki Yamakage, Jun-Ichi Satoh, Akiyoshi Namiki

    ANESTHESIOLOGY   105 ( 4 )   753 - 763   2006.10

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  • Intraoperative cardiac arrest due to coronary vasospasm after tourniquet release - A case report

    Jun-Ichi Satoh, Johji Arakawa, Hideya Ohmori, Hiromi Takahashi, Michiaki Yamakage, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   55 ( 4 )   460 - 463   2006.4

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  • Performance of three systems for warming intravenous fluids at different flow rates Reviewed

    J Satoh, M Yamakage, SI Wasaki, A Namiki

    ANAESTHESIA AND INTENSIVE CARE   34 ( 1 )   46 - 50   2006.2

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  • Effects of the Chinese herbal medicines Bupleuri radix, Ginseng radix, and Zingiberis rhizoma on lymphatic vessel activity in rats Reviewed

    Michiaki Yamakage, Jun-Ichi Hattori, Jun-Ichi Satoh, Akiyoshi Namiki

    AMERICAN JOURNAL OF CHINESE MEDICINE   34 ( 6 )   1063 - 1068   2006

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  • Changes in concentrations of free propofol by modification of the solution Reviewed

    M Yamakage, S Iwasaki, J Satoh, A Namiki

    ANESTHESIA AND ANALGESIA   101 ( 2 )   385 - 388   2005.8

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    DOI: 10.1213/01.ANE.0000154191.86608AC

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  • Comparative study between propofol in a long-chain triglyceride and propofol in a medium/long-chain triglyceride during sedation with target-controlled infusion Reviewed

    M Yamakage, S Iwasaki, SW Jeong, SI Ishiyama, A Namiki

    ANAESTHESIA AND INTENSIVE CARE   33 ( 3 )   351 - 355   2005.6

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  • Effects of lidocaine jelly with 1:100,000 epinephrine on the incidence and intensity of epistaxis during nasotracheal intubation

    Yasushi Fukui, Michiaki Yamakage, Akiyoshi Namiki

    Journal of Japanese Dental Society of Anesthesiology   33 ( 5 )   681 - 686   2005

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  • Reductions in levels of bacterial superantigens/cannabinoids by plasma exchange in a patient with severe toxic shock syndrome Reviewed

    S Kohro, H Imaizumi, M Yamakage, Y Masuda, A Namiki, Y Asai

    ANAESTHESIA AND INTENSIVE CARE   32 ( 4 )   588 - 591   2004.8

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  • Design of oxygen delivery systems influences both effectiveness and comfort in adult volunteers Reviewed

    H Sasaki, M Yamakage, S Iwasaki, M Mizuuchi, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   50 ( 10 )   1052 - 1055   2003.12

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  • Interaction between volatile anesthetics and hypoxia in porcine tracheal smooth muscle Reviewed

    XD Chen, M Yamakage, N Tsujiguchi, Y Kamada, A Namiki

    ANESTHESIA AND ANALGESIA   91 ( 4 )   996 - 1002   2000.10

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  • Utility of an infrared ear thermometer as an intraoperative core temperature monitor Reviewed

    Y. Kamada, N. Miyamoto, M. Yamakage, N. Tsujiguchi, A. Namiki

    Japanese Journal of Anesthesiology   48 ( 10 )   1121 - 1125   1999

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  • Preventive effect of fluid warmer system on hypothermia induced by rapid intravenous infusion Reviewed

    Masanori Yamauchi, Yoshito Nakayama, Michiaki Yamakage, Hideaki Tsuchida, Hiroshi Iwasaki, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   47 ( 5 )   606 - 610   1998.5

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  • The effect of scalp infiltration with bupivacaine on blood coagulability and fibrinolysis in neurovascular surgery

    Naoki Tsujiguchi, Shinji Kohro, Johji Arakawa, Tetsuo Omote, Michiaki Yamakage, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   47 ( 3 )   318 - 321   1998.3

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  • Evaluation of Risks for Postoperative Pulmonary Complications using a Preoperative Consultation System

    Masaki Toriyabe, Michiaki Yamakage, Tomoyuki Kawamata, Yasuyuki Homma, Saori Kurosawa, Yasuyuki Susa, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   47 ( 7 )   892 - 893   1998

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  • An analysis of the status of surgical transfusion in Sapporo Medical University Hospital Reviewed

    M. Yamakage, Y. Homma, M. Edanaga, S. Kohro, A. Namiki

    Japanese Journal of Anesthesiology   47 ( 1 )   85 - 89   1998

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  • Evaluation method of surgical stress. Evaluation method of surgical stress. Evaluation using the blood coagulation fibrinolytic system, especially thromboelastography.

    JJSCA   17 ( 9 )   502 - 504   1997

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    DOI: 10.2199/jjsca.17.502

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  • Direct inhibitory mechanisms of halothane on human platelet aggregation Reviewed

    S Kohro, M Yamakage

    ANESTHESIOLOGY   85 ( 1 )   96 - 106   1996.7

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  • Anesthetic management for magnetic resonance imaging of children Reviewed

    Y. Nikae, M. Yamakage, Y. Tarumi, D. Horikawa, K. Tamiya, S. Kawana, A. Namiki

    Journal of Anesthesia   10 ( 1 )   86 - 87   1996

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    DOI: 10.1007/BF02482078

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  • INHIBITORY EFFECTS OF THIOPENTAL KETAMINE, AND PROPOFOL ON VOLTAGE-DEPENDENT CA2+ CHANNELS IN PORCINE TRACHEAL SMOOTH-MUSCLE CELLS Reviewed

    M YAMAKAGE, CA HIRSHMAN, TL CROXTON

    ANESTHESIOLOGY   83 ( 6 )   1274 - 1282   1995.12

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  • Evaluation of a forced-air warming system during spinal anesthesia Reviewed

    Michiaki Yamakage, Shin Kawana, Masanori Yamauchi, Shinji Kohro, Akiyoshi Namiki

    Journal of Anesthesia   9 ( 1 )   93 - 95   1995.3

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    DOI: 10.1007/BF02482048

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  • The utility of thermistor attached tracheal tube for pediatric patients in cardiac surgery

    M. Yamauchi, H. Watanabe, H. Imaizumi, S. Sumita, M. Yamakage, A. Namiki

    Japanese Journal of Anesthesiology   44 ( 8 )   1159 - 1164   1995

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  • INHIBITORY EFFECTS OF HALOTHANE ON HIGH K+-INDUCED CANINE TRACHEAL SMOOTH-MUSCLE CONTRACTION AND INTRACELLULAR CA2+ INCREMENT Reviewed

    M YAMAKAGE, T KAWAMATA, S KOHRO, A NAMIKI

    ACTA ANAESTHESIOLOGICA SCANDINAVICA   38 ( 8 )   816 - 819   1994.11

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  • EFFECTS OF INDUCED HYPOTENSION ON ARTERIAL BLOOD-GASES UNDER SPONTANEOUS BREATHING Reviewed

    M YAMAKAGE, H IWASAKI, K SATOH, A NAMIKI

    ACTA ANAESTHESIOLOGICA SCANDINAVICA   38 ( 4 )   368 - 371   1994.5

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  • CHANGES IN WORK OF BREATHING DURING CONTINUOUS POSITIVE AIRWAY PRESSURE WITH INCREASED AIRWAY-RESISTANCE Reviewed

    Y YAMAZAKI, M YAMAKAGE, Y UJIKE, A NAMIKI

    CHEST   105 ( 3 )   860 - 863   1994.3

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  • Perianesthetic Airway/Respiratory Complications in Pediatric Cases with Specific Congenital Diseases.

    YAMAKAGE Michiaki, TAMIYA Keiko, HOMMA Yasuyuki, MAEDA Toshiaki, NAMIKI Akiyoshi

    JJSCA   14 ( 4 )   322 - 328   1994

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    The incidence of perianesthetic airway/respiratory complications was evaluated in 58 pediatric patients with specific congenital diseases such as inborn errors. Twenty-one cases (36.2%) were complicated with airway/respiratory troubles: difficult intubation and difficult airway support. Most of the troubles (65.4%) occurred during the induction of the anesthesia. The complications did not correlate with sex, age or anesthetic method. The more times the patients were anesthetized, the more they had complications.<br>For pediatric cases with specific congenital disease, particularly those which require repeated anesthesia, it is important to be very alert for airway troubles.

    DOI: 10.2199/jjsca.14.322

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  • Complications of pediatric spinal anesthesia Reviewed

    M. Yamakage, D. Horikawa, K. Tamiya, A. Namiki

    Japanese Journal of Anesthesiology   43 ( 9 )   1362 - 1365   1994

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  • Changes in lryngeal Mask airway cuff pressure under general anesthesia with and without nitrous oxide

    Hiroshi Iwasaki, Michiaki Yamakage, Junko Lee, Yutaka Yamazaki, Akinori Kirita, Akiyoshi Namiki

    Journal of Anesthesia   7 ( 4 )   496 - 500   1993.10

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    DOI: 10.1007/s0054030070496

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  • INHIBITORY EFFECTS OF 4 INHALED ANESTHETICS ON CANINE TRACHEAL SMOOTH-MUSCLE CONTRACTION AND INTRACELLULAR CA-2+ CONCENTRATION Reviewed

    M YAMAKAGE, S KOHRO, T KAWAMATA, A NAMIKI

    ANESTHESIA AND ANALGESIA   77 ( 1 )   67 - 72   1993.7

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  • THE UTILITY OF TRACHEAL TEMPERATURE MONITORING Reviewed

    M YAMAKAGE, S KAWANA, H WATANABE, A NAMIKI

    ANESTHESIA AND ANALGESIA   76 ( 4 )   795 - 799   1993.4

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  • EFFECTS OF HALOTHANE AND ISOFLURANE ON CYTOSOLIC CALCIUM-ION CONCENTRATIONS AND CONTRACTION IN THE VASCULAR SMOOTH-MUSCLE OF THE RAT AORTA Reviewed

    H TSUCHIDA, H NAMBA, M YAMAKAGE, S FUJITA, E NOTSUKI, A NAMIKI

    ANESTHESIOLOGY   78 ( 3 )   531 - 540   1993.3

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  • THE INHIBITORY EFFECTS OF POSITIVE END-EXPIRATORY PRESSURE (PEEP) ON PHRENIC MOTONEURONAL ACTIVITY IN CATS Reviewed

    M YAMAKAGE, M AOKI, A NAMIKI, M IKEDA

    ANESTHESIA AND ANALGESIA   76 ( 1 )   80 - 84   1993.1

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  • Changes in 3 different kinds of body temperature during CPR for DOA patients

    M. Yamakage, M. Kotaki, T. Omote, I. Yoshida, A. Namiki

    Japanese Journal of Anesthesiology   42 ( 2 )   255 - 258   1993

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  • Three Cases of Complications Following Flumazenil Administration. Hyperventilation, Tonic Convulsion and Myoclonus Epilepsy.:Hyperventilation, Tonic Convulsion and Myoclonus Epilepsy

    YAMAKAGE Michiaki, NAKANO Satoru, IWASAKI Hiroshi, KOHRO Shinji, NAMIKI Akiyoshi

    JJSCA   13 ( 6 )   589 - 592   1993

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    We report three cases of complications following the administration of flumazenil in order to antagonize the effect of midazolam used pre- or intra-operatively. <Case 1>: A 25-year-old woman showed hyperventilation syndrome after operation on her hand under axillary block and midazolam sedation. <Case 2>: A 66-year-old man with a history of tonic and clonic convulsions due to traffic accident showed tonic convulsion after an operation on his hand under general anesthesia. <Case 3>: A 11-year-old girl with Down's syndrome who had myoclonus epilepsy during infancy showed myoclonus epilepsy after an examination of her hip joints under general anesthesia. We recommend that flumazenil be administered after careful consideration of the patient's background. Flumazenil should be avoided with patients who have histories of convulsions or epilepsy.

    DOI: 10.2199/jjsca.13.589

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  • Survey of Cardiac Arrests during Anesthesia and Surgery in the Past Ten Years.

    NISHIKAWA Kohki, YAMAKAGE Michiaki, FUJITA Satoshi, KAWAMATA Mikito, NAMIKI Akiyoshi

    JJSCA   13 ( 2 )   131 - 136   1993

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    Cardiac arrests, excluding those associated with cardiac surgery, occurred in 29 (0.087%) of 33, 194 non-cardiac surgery cases out of 36, 159 patients who had general, spinal and/or epidural anesthesia in our hospital during the ten years from 1981 to 1990. Twenty-five of them were successfully resuscitated without any complications, while the remaining four patients died. The causes of cardiac arrest in the 29 patients were as follows: possible coronary artery spasm due to preoperative unstable angina in two;preoperative hypovolemia in three; massive bleeding in nine; anaphylactic shock in six; intravenous injection of epinephrine in two; hypotension due to deep anesthesia in two; hypoventilation in one; and unknown causes in four.<br>During anesthesia and surgery, we must comstantly be on the lookout for the first signs of cardiac arrest and treat in the early phase. Anesthetists should always use adequate instrumentation, such as pulse oximeter and capnometer, for the management of anesthesia.

    DOI: 10.2199/jjsca.13.131

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  • Cerebral blood flow velocity and electroencephalogram for the evaluation of intraoperative brain function during intrathoracic hyperthermia

    N. Kanaya, Y. Kobayashi, M. Yamakage, H. Tsuchida, A. Watanabe, A. Namiki

    Japanese Journal of Anesthesiology   42 ( 3 )   450 - 454   1993

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  • DIRECT INHIBITORY MECHANISMS OF HALOTHANE ON CANINE TRACHEAL SMOOTH-MUSCLE CONTRACTION Reviewed

    M YAMAKAGE

    ANESTHESIOLOGY   77 ( 3 )   546 - 553   1992.9

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  • CHANGES IN VENTILATORY PATTERN AND ARTERIAL OXYGEN-SATURATION DURING SPINAL-ANESTHESIA IN MAN Reviewed

    M YAMAKAGE, A NAMIKI, H TSUCHIDA, H IWASAKI

    ACTA ANAESTHESIOLOGICA SCANDINAVICA   36 ( 6 )   569 - 571   1992.8

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  • A Retrospective Study of Anesthesia to Patients with Cardiac Tumor.

    KOHRO Shinji, YAMAKAGE Michiaki, TUCHIDA Hideaki, SATOH Osamu, NAMIKI Akiyoshi

    JJSCA   12 ( 7 )   787 - 791   1992

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    We reported on 12 cases that underwent the operations for the resection of cardiac tumor from 1981 to 1991. There were 8 cases with left atrial tumor, 2 cases with right atrial one, 1 case with right ventricular one, and 1 case with left ventricular one.<br>Perioperative complications were severe hypotension due to disturbance of blood flow (3 cases) and heart blook (7 cases). We coped with disturbance of blood flow by changing the patient's position (2 cases) and administration of catecholamine (1 case), and heart blook by using transient (5 cases) and permanent (2 cases) pacemaker for sick sinus syndrome.

    DOI: 10.2199/jjsca.12.787

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  • Effects of Age on the Spread of Neural Blockade and Pharmacokinetics in Epidural Anesthesia with Lidocaine.

    YAMAKAGE Michiaki, OMOTE Keiichi, MATSUMOTO Maki, NAMIKI Akiyoshi

    JJSCA   11 ( 4 )   466 - 470   1991

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    Effects of age on the spread of neural blockade and pharmacokinetics in lumbar epidural analgesia using 10ml of 2% lidocaine were studied. Patients were divided into two groups; a young group (under 60 yr old) and an old group (over 60 yr old).<br>There was a significant correlation between the spinal segment number of analgesia and age (r=0.69, p<0.05). Peak plasma concentration of lidocaine in the old group was significantly higher than that in the young group (p<0.01). In order to investigate the difference of plasma concentration between the two groups, these results were applied to a one-compartment model. Consequently, it was revealed that the absorption rate constant per segment in the old group was higher than that in the young group.<br>It is important to be aware of the toxicity of local anesthetics when epidural anesthe-sia is performed in older patients.

    DOI: 10.2199/jjsca.11.466

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  • Utility of Bullard intubating laryngoscope with a special stylet in two cases of difficult tracheal intubation Reviewed

    M. Yamakage, Y. Yamazaki, H. Iwasaki, A. Namiki

    Japanese Journal of Anesthesiology   40 ( 9 )   1404 - 1406   1991

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  • Case report of 4 patients with prolonged respiratory. Depression in the postoperative period

    I. Yoshida, M. Yamakage, H. Iwasaki, A. Namiki

    Hiroshima Journal of Anesthesia   27 ( 1 )   45 - 49   1991

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  • A case report of monitoring neuromuscular blockade during anesthesia in a patient with facioscapulohumeral muscle dystrophy Reviewed

    M. Yamakage, H. Iwasaki, S. Kawana, T. Ishima, A. Namiki

    Japanese Journal of Anesthesiology   40 ( 1 )   105 - 108   1991

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  • The evaluation of tracheal temperature to monitor core temperature in various operations Reviewed

    M. Yamakage, S. Kawana, H. Watanabe, A. Namiki

    Japanese Journal of Anesthesiology   39 ( 12 )   1613 - 1618   1990

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  • 脳脊髄液減少症に対して,三度にわたる腹臥位X線透視下ブラッドパッチにより症状が改善した一症例

    枝長充隆, 諸原清香, 濱田耕介, 小松克也, 立花俊祐, 山蔭道明

    日本呼吸療法医学会学術集会プログラム・抄録集   46th (Web)   2024

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    澤下泰明, 平田直之, 吉川裕介, 寺田拡文, 山蔭道明

    日本麻酔科学会学術集会(Web)   67th   2020

  • 妊娠高血圧症を合併した多発性硬化症の妊婦に硬膜外麻酔のみで帝王切開を施行した1症例

    佐藤優真, 君塚基修, 吉川裕介, 枝長充隆, 山蔭道明

    日本臨床麻酔学会誌   38 ( 6 )   2018

  • Anesthetic Management with Percutaneous Cardiopulmonary Support for Emergency Tracheotomy in a Patient with a Thyroid Tumor who Had Severe Tracheal Stenosis from Thyroid Tumor

    横山竜也, 新山幸俊, 吉川裕介, 高田幸昌, 山蔭道明

    麻酔   67 ( 11 )   2018

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    畠山陽介, 枝長充隆, 吉川裕介, 松本友美, 寺田拡文, 木井菜摘, 山蔭道明

    Cardiovascular Anesthesia   22 ( Suppl )   2018

  • In reply: Desflurane anesthesia and cognitive function

    Shunsuke Tachibana, Tomo Hayase, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   31 ( 4 )   637 - 637   2017.8

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    DOI: 10.1007/s00540-017-2382-7

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  • Anesthetic Management of a Patient with Intravenous Leiomyomatosis Extending into the Right Atrium

    66 ( 5 )   542 - 545   2017.5

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  • Several new Japanese guidelines issued

    Michiaki Yamakage

    JOURNAL OF ANESTHESIA   31 ( 2 )   161 - 162   2017.4

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  • 肺胞蛋白症に対する全肺洗浄における全身麻酔管理についての検討

    笠羽一敏, 吉川裕介, 山蔭道明

    麻酔科学サマーセミナー   14th   2017

  • 限局性の下行大動脈解離が生じたバルーン大動脈弁形成術(BAV)の1症例

    佐藤慧, 吉川裕介, 茶木友浩, 枝長充隆, 山蔭道明

    Cardiovascular Anesthesia   21 ( Suppl )   2017

  • Efficacy of Ultrasound-guided Caudal Epidural Block for Transrectal Ultrasound-guided Prostate Biopsy

    65 ( 5 )   511 - 515   2016.5

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  • Anesthetic Management for Non-cardiac Surgery in a Patient with Severe Pulmonary Arterial Hypertension

    65 ( 5 )   526 - 529   2016.5

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  • Usefulness of the Selective Anti-Vasopressin Receptor Antagonist Tolvaptan in Critically Ill Patients

    40 ( 3 )   231 - 236   2016.3

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  • Comparison of fluid leakage across endotracheal tube cuffs using a three-dimensional printed model of the human trachea

    Journal of anesthesia   30 ( 3 )   510 - 513   2016

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  • D-LACTATE IS A FEASIBLE BIOMARKER FOR DIAGNOSIS OF INTESTINAL ISCHEMIA IN THE ICU

    Shinichiro Yoshida, Yoshiki Masuda, Hiroomi Tatsumi, Hitoshi Imaizumi, Kanako Takahashi, Satoshi Kazuma, Yoichi Katayama, Michiaki Yamakage

    CRITICAL CARE MEDICINE   43 ( 12 )   2015.12

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  • 神経伝導検査により診断した術後横隔神経麻痺の2症例

    数馬 聡, 升田 好樹, 今泉 均, 巽 博臣, 後藤 京子, 高橋 科那子, 今井 富裕, 山蔭 道明

    日本集中治療医学会雑誌   22 ( 1 )   49 - 50   2015.1

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    DOI: 10.3918/jsicm.22.49

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  • Can age-related mitochondrial dysfunction affect volatile anesthetic potency?

    Michiaki Yamakage

    JOURNAL OF ANESTHESIA   28 ( 6 )   805 - 806   2014.12

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  • 最近のペインクリニック (特集 最新の腰痛・膝関節痛の診療)

    新谷 知久, 山蔭 道明

    臨牀と研究   91 ( 11 )   1465 - 1468   2014.11

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    Other Link:: http://search.jamas.or.jp/link/ui/2015059000

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  • 局所麻酔薬の頭皮下投与後の血中濃度

    山下 美妃, 向 祐志, 戸田 貴大, 猪爪 信夫, 郡 修徳, 茶木 友浩, 杉野 繁一, 早瀬 知, 山蔭 道明

    臨床薬理   45 ( Suppl. )   S267 - S267   2014.11

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    Ichushi

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  • Efficacy and Safety of Sugammadex (Org 25969) in Reversing Moderate Neuromuscular Block Induced by Rocuronium or Vecuronium in Japanese Patients

    63 ( 10 )   1075 - 1082   2014.10

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  • Two cases of chronic pain with different clinical courses supported by MMPI intervention

    SUGIME Fumiyuki, YAMAUCHI Masanori, NIIYA Tomohisa, IWASAKI Soushi, YAMAKAGE Michiaki

    JJSPC   21 ( 1 )   40 - 44   2014.2

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    DOI: 10.11321/jjspc.13-0027

    Ichushi

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  • 特発性肺高血圧症を合併した成人の部分肺静脈還流異常症修復術の麻酔経験

    西原教晃, 川口亮一, 吉川裕介, 時永泰行, 山蔭道明

    Cardiovascular Anesthesia   18 ( Suppl )   2014

  • Postoperative pain management for spine surgery : perspective of anesthesiology

    56 ( 13 )   1571 - 1575   2013.12

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  • Regulation of body temperature

    37 ( 9 )   991 - 995   2013.9

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  • 多発性骨髄腫の疼痛管理の問題点

    水口 亜紀, 渡辺 昭彦, 佐藤 明美, 山内 正憲, 山蔭 道明

    日本緩和医療学会学術大会プログラム・抄録集   18回   514 - 514   2013.6

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    Ichushi

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  • 難治性慢性疼痛患者の満足度に与える因子の検討

    杉目 史行, 山内 正憲, 新谷 知久, 岩崎 創史, 水上 奈穂美, 大森 英哉, 一宮 尚裕, 山蔭 道明

    日本ペインクリニック学会誌   20 ( 3 )   362 - 362   2013.6

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    Ichushi

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  • 小児の術後鎮痛における経静脈的自己調節鎮痛法の現状についての後ろ向き調査

    水上 奈穂美, 杉目 史行, 山内 正憲, 山蔭 道明

    日本ペインクリニック学会誌   20 ( 3 )   375 - 375   2013.6

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    Ichushi

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  • 棘上筋下のガングリオンを超音波ガイド下に穿刺・吸引した1症例

    関根 利佳, 山内 正憲, 杉目 史行, 佐々木 英昭, 山蔭 道明, 一宮 尚裕

    日本ペインクリニック学会誌   20 ( 3 )   414 - 414   2013.6

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  • 札幌医大附属病院緩和ケアチームにおけるオピオイド使用動向と今後の課題

    渡邊 昭彦, 水口 亜紀, 佐藤 明美, 山内 正憲, 山蔭 道明

    日本緩和医療学会学術大会プログラム・抄録集   18回   385 - 385   2013.6

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  • Preoperative Epidural Catheterization under Radiographic Monitoring

    62 ( 4 )   488 - 494   2013.4

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  • 胸部大動脈瘤ステントグラフト内挿術中にアデノシン三リン酸(ATP)誘発性気管支痙攣を生じた3症例

    高田 幸昌, 川岸 俊也, 木井 菜摘, 樋口 美沙子, 山内 正憲, 山蔭 道明

    麻酔   62 ( 4 )   402 - 405   2013.4

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  • 局所麻酔薬の過剰投与に対する脂肪乳剤の有用性

    藤本 万理恵, 大瀬戸 翔大, 山下 美妃, 郡 修徳, 新谷 知久, 山内 正憲, 山蔭 道明

    日本薬学会年会要旨集   133年会 ( 4 )   129 - 129   2013.3

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  • 超音波ガイド下中腋窩線および肋骨弓下腹横筋膜面ブロック Thiel遺体を用いた薬液の広がりの検討

    室内 健志, 山内 正憲, 魏 慧玲, 高田 幸昌, 水口 亜紀, 山蔭 道明, 藤宮 峯子

    麻酔   62 ( 1 )   60 - 63   2013.1

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  • Pharmacokinetics and safety of 6% hydroxyethyl starch 130/0.4 in healthy male volunteers of Japanese ethnicity after single infusion of 500 ml solution

    YAMAKAGE Michiaki, BEPPERLING Frank, WARGENAU Manfred, MIYAO Hideki

    26 ( 6 )   851 - 857   2012.12

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  • 体温マッサージ療法がアトピー・アレルギー性皮膚炎に与える影響

    佐々木 英昭, 山内 正憲, 山蔭 道明, 山本 みえ子

    臨床体温   30 ( 1 )   49 - 49   2012.12

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  • デコルテマッサージがアトピー・アレルギー性皮膚炎に与える影響

    佐々木 英昭, 山内 正憲, 山蔭 道明, 山本 みえ子

    臨床体温   30 ( 1 )   3 - 7   2012.12

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  • 1980年〜2010年の当院での術中心停止の変遷と全国麻酔関連偶発症例における心停止の比較検討

    川島 如仙, 岩崎 創史, 山内 正憲, 山蔭 道明

    蘇生   31 ( 3 )   140a - 140a   2012.10

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    DOI: 10.11414/jjreanimatology.31.140a

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  • Risk factors for gastric distension in patients with acute appendicitis : a retrospective cohort study

    KIMURA Yoshinobu, YAMAUCHI Masanori, INOUE Hikaru, KIMURA Saori, YAMAKAGE Michiaki, AIMONO Mako, SUMITA Shinzou

    26 ( 4 )   574 - 578   2012.8

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  • Ultrasound-guided and radiographic monitoring-assisted peripherally inserted central catheterization

    Mitsutaka Edanaga, Ryu Azumaguchi, Michiaki Yamakage

    JOURNAL OF ANESTHESIA   26 ( 4 )   623 - 624   2012.8

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    DOI: 10.1007/s00540-012-1374-x

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  • 重度の拘束性換気障害を合併した脊髄性進行性筋萎縮症患者の麻酔経験

    宇野 あゆみ, 新山 幸俊, 橘 信子, 山内 正憲, 渡邊 昭彦, 山蔭 道明

    麻酔   61 ( 8 )   830 - 833   2012.8

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  • Improved phantom limb pain and phantom limb sensation after operation for forequarter amputation with oral gabapentin : reports of 3 cases

    MIZUKAMI Naomi, NIIYA Tomohisa, YAMAUCHI Masanori, TACHIBANA Nobuko, TAKAHASHI Mika, YAMAKAGE Michiaki

    JJSPC   19 ( 2 )   111 - 114   2012.6

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    DOI: 10.11321/jjspc.11-0013

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  • カルバマゼピン血中濃度測定に基づく抗てんかん薬のローテーション

    橘 信子, 山内 正憲, 渡邊 昭彦, 高橋 三佳, 山澤 弦, 御村 光子, 山蔭 道明

    日本ペインクリニック学会誌   19 ( 3 )   389 - 389   2012.6

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  • 難治性疼痛患者への介入におけるMMPIの有用性

    杉目 史行, 山内 正憲, 水口 亜紀, 新谷 知久, 渡邊 昭彦, 大森 英哉, 山蔭 道明

    日本ペインクリニック学会誌   19 ( 3 )   322 - 322   2012.6

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  • 緩和ケアチーム介入患者における集中治療室利用症例の検討

    渡邊 昭彦, 水口 亜紀, 高橋 三佳, 水上 奈穂美, 藤井 明美, 山内 正憲, 山蔭 道明

    日本緩和医療学会学術大会プログラム・抄録集   17回   368 - 368   2012.6

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  • 緩和ケアチームがかかわった骨髄移植関連症例における鎮痛剤の使用状況

    渡邊 昭彦, 水口 亜紀, 山内 正憲, 山蔭 道明

    日本ペインクリニック学会誌   19 ( 3 )   416 - 416   2012.6

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  • がん患者の疼痛緩和におけるトラムセットの有効性

    水口 亜紀, 渡邊 昭彦, 山内 正憲, 山蔭 道明

    日本ペインクリニック学会誌   19 ( 3 )   417 - 417   2012.6

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  • 呼吸不全と敗血症性ショックを呈した患者の体外膜型人工肺補助下での縦隔洗浄ドレナージの麻酔経験

    河村 真衣子, 黒田 浩光, 渋川 圭介, 鎌田 康宏, 山内 正憲, 山蔭 道明

    臨床麻酔   36 ( 4 )   607 - 610   2012.4

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  • 【ペインクリニック教育の課題と展望】 学生・初期臨床研修医が理解と興味を持つペインクリニック教育 札幌医科大学医学部

    山内 正憲, 山蔭 道明

    ペインクリニック   33 ( 3 )   335 - 342   2012.3

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  • 痛みの評価

    山内 正憲, 山蔭 道明

    ペインクリニック   33 ( 2 )   271 - 279   2012.2

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  • Efficacy of Glucose Infusion for the Inhibition of Breakdown of Fat Tissue and Muscle Protein under Remifentanil Anesthesia

    澤田敦史, 吉川裕介, 山内正憲, 渡辺昭彦, 山蔭道明

    麻酔   61 ( 4 )   2012

  • 確定診断まで時間を要し疼痛管理に難渋したEwing肉腫の一症例

    水口 亜紀, 渡辺 昭彦, 高橋 三佳, 山内 正憲, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S370 - S370   2011.10

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  • 札幌医科大学附属病院緩和ケアチームにおける近年の活動実績と今後の課題

    高橋 三佳, 渡辺 昭彦, 水口 亜紀, 山内 正憲, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S369 - S369   2011.10

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  • 30秒で予測できる新型電子体温計の有用性

    桶谷 章夫, 山内 正憲, 新山 幸俊, 山蔭 道明, 諸原 清香

    日本臨床麻酔学会誌   31 ( 6 )   S518 - S518   2011.10

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  • 術中心停止症例の検討 当院における1980年代、1990年代と2000年代の変遷

    川島 如仙, 岩崎 創史, 山内 正憲, 渡辺 昭彦, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S271 - S271   2011.10

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  • 札幌医科大学附属病院緩和ケアチームでのトラマドール使用状況と今後の課題

    渡辺 昭彦, 高橋 三佳, 水口 亜紀, 山内 正憲, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S271 - S271   2011.10

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  • プレガバリン内服治療中に小脳腫瘍が見つかった一例

    並木 正伸, 山内 正憲, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S507 - S507   2011.10

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  • 腕神経叢ブロックとプロポフォールを用いて管理したMELAS症候群の1症例

    立花 俊祐, 山内 正憲, 岩崎 創史, 渡辺 昭彦, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S443 - S443   2011.10

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  • 重度の拘束性呼吸障害を合併した脊髄性進行性筋萎縮症患者の麻酔経験

    宇野 あゆみ, 新山 幸俊, 橘 信子, 山内 正憲, 渡辺 昭彦, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S464 - S464   2011.10

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  • 麻酔科医によるテルモ社製CVレガフォースEXの使用感について

    玉城 敬史, 山内 正憲, 渡辺 昭彦, 山蔭 道明

    日本臨床麻酔学会誌   31 ( 6 )   S473 - S473   2011.10

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  • Intrathecal neurolytic block in a patient with refractory cancer pain

    WATANABE Akihiko, YAMAKAGE Michiaki

    25 ( 4 )   603 - 605   2011.8

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  • The usefulness of an earphone-type infrared tympanic thermometer during cardiac surgery with cardiopulmonary bypass : clinical report

    MASAMUNE Taishi, YAMAUCHI Masanori, WADA Keiichi, IWASHITA Hironobu, OKUYAMA Katsumi, INO Hirofumi, YAMAKAGE Michiaki, ISHIYAMA Tadahiko, MATSUKAWA Takashi

    25 ( 4 )   576 - 579   2011.8

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  • 30秒で測定できる新型電子体温計の小児での使用経験

    諸原 清香, 新谷 知久, 山内 正憲, 山蔭 道明

    臨床体温   29 ( 1 )   73 - 73   2011.8

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  • 外傷性多発骨折に対する緊急手術の麻酔終了直後に発症した脂肪塞栓症候群の1例

    吉田 司, 新谷 知久, 山内 正憲, 成松 英智, 山蔭 道明

    臨床麻酔   35 ( 8 )   1294 - 1296   2011.8

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  • Utility of ultrasound imaging for epidural blood patch in postdural puncture headache patients after Caesarean section

    60 ( 7 )   870 - 872   2011.7

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  • 骨転移が疑われた慢性腰下肢痛に対し、集学的アプローチにより骨髄炎との診断・治療に繋がった1例

    高橋 三佳, 藤井 明美, 米田 舞, 吉永 敏弘, 渡辺 昭彦, 山内 正憲, 山蔭 道明

    日本緩和医療学会学術大会プログラム・抄録集   16回   541 - 541   2011.6

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  • 頭頸部放射線治療に伴う重症口内炎に対する痛み治療の満足度評価の検討

    水上 奈穂美, 渡邊 昭彦, 山内 正憲, 高橋 三佳, 山蔭 道明

    日本緩和医療学会学術大会プログラム・抄録集   16回   396 - 396   2011.6

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  • 神経ブロック直前に薬剤性血小板減少症が疑われた帯状疱疹神経痛の1例

    新谷 知久, 山内 正憲, 山蔭 道明, 渡邊 昭彦, 水口 亜紀

    日本ペインクリニック学会誌   18 ( 3 )   324 - 324   2011.6

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  • 【慢性疼痛に対するオピオイドの使用戦略】 各施設の慢性疼痛に対するオピオイドの使用戦略 札幌医科大学附属病院 当科における経緯と展望

    山内 正憲, 山蔭 道明

    ペインクリニック   32 ( 3 )   336 - 344   2011.3

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  • Colloid solutions: A clinical update

    Tomi T. Niemi, Ryo Miyashita, Michiaki Yamakage

    Journal of Anesthesia   24 ( 6 )   913 - 925   2010.12

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    DOI: 10.1007/s00540-010-1034-y

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  • 肩関節術後痛に対する鎖骨上アプローチでの持続腕神経叢ブロックの効果

    新谷 知久, 山内 正憲, 水上 奈穂美, 新山 幸俊, 大曽根 順平, 本間 広則, 川股 知之, 山蔭 道明, 廣瀬 總明

    麻酔   59 ( 11 )   1385 - 1390   2010.11

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  • 右心房内を占拠した巨大心臓腫瘍の1症例

    宮下 龍, 君島 知彦, 濱田 耕介, 浦濱 聡, 山内 正憲, 山蔭 道明

    Cardiovascular Anesthesia   14 ( Suppl. )   170 - 170   2010.10

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  • 整形外科領域における痛み 整形外科疾患に対するペインクリニック

    山内 正憲, 山蔭 道明

    北海道整形災害外科学会雑誌   52 ( 1 )   20 - 24   2010.8

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  • 癌患者および慢性疼痛患者の下肢冷感に対する漢方薬の有効性

    高橋 三佳, 山内 正憲, 渡辺 昭彦, 高橋 和伸, 水上 奈穂美, 新谷 知久, 山蔭 道明

    臨床体温   28 ( 1 )   22 - 26   2010.8

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  • 癌性および慢性疼痛患者の下肢冷感に対する漢方薬の有効性

    高橋 三佳, 渡邊 昭彦, 水上 奈穂美, 新谷 知久, 山内 正憲, 渡辺 廣昭, 山蔭 道明

    臨床体温   28 ( 1 )   45 - 45   2010.8

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  • A Case Report of the Successful Nasotracheal Intubation Using Airway Scope^【○!R】 and Cuff Inflation Technique

    KAWABATA Kazuhiro, CHIDA Norifumi, YAMAUCHI Masanori, YAMAKAGE Michiaki

    38 ( 3 )   311 - 312   2010.7

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  • Depth of anesthesia and emergence from anesthesia

    234 ( 2 )   131 - 135   2010.7

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  • 頭頸部放射線治療に伴う重症口内炎に対する痛み治療の満足度の調査

    水上 奈穂美, 渡邊 昭彦, 山内 正憲, 橘 信子, 山蔭 道明

    日本ペインクリニック学会誌   17 ( 3 )   366 - 366   2010.6

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  • 超音波装置による仙尾靱帯同定の有用性

    橘 信子, 山内 正憲, 水上 奈穂美, 新谷 知久, 渡邊 昭彦, 山蔭 道明

    日本ペインクリニック学会誌   17 ( 3 )   363 - 363   2010.6

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  • Recent Topics on Inhalation Anesthetics

    YAMAKAGE Michiaki, SAWADA Atsushi

    30 ( 3 )   342 - 355   2010.5

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  • バルーン式ディスポーザブル持続注入器の投与速度に及ぼす温度と抵抗圧の影響

    福岡 英子, 山内 正憲, 水上 奈穂美, 山蔭 道明, 渡辺 廣昭, 並木 昭義

    臨床体温   27 ( 1 )   50 - 54   2009.8

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  • ロクロニウムにアナフィラキシー反応を示した心臓外科手術の1症例

    望月 宏樹, 山蔭 道明, 吉田 真一郎, 古瀬 晋吾, 山内 正憲, 並木 昭義

    臨床麻酔   33 ( 6 )   1051 - 1053   2009.6

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  • General Aspects of a New Local Anesthetic, Levobupivacaine

    YAMAKAGE Michiaki

    29 ( 3 )   275 - 289   2009.5

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  • Two cases of Menkes disease: airway management and dental fragility

    J. Yamashita, M. Yamakage, S. Kawana, A. Namiki

    ANAESTHESIA AND INTENSIVE CARE   37 ( 2 )   332 - 333   2009.3

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  • 麻酔科クリニカルクラークシップにおけるバイタルサインの教育

    樋口 美沙子, 杉野 繁一, 平田 直之, 古瀬 晋吾, 山蔭 道明, 久米田 幸弘, 並木 昭義

    麻酔   58 ( 3 )   393 - 393   2009.3

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  • 神経ブロックに特化した携帯型超音波診断装置S-Nerve

    本間 広則, 山蔭 道明, 君塚 基修, 山内 正憲, 並木 昭義

    臨床麻酔   33 ( 2 )   253 - 257   2009.2

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  • Guideline-oriented perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease

    Michiaki Yamakage, Sohshi Iwasaki, Akiyoshi Namiki

    JOURNAL OF ANESTHESIA   22 ( 4 )   412 - 428   2008.11

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    DOI: 10.1007/s00540-008-0650-2

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  • ペインビジョンによる健常者の痛み程度の測定

    望月 宏樹, 新谷 知久, 西條 博正, 水上 奈緒美, 山内 正憲, 山蔭 道明, 並木 昭義

    ペインクリニック   29 ( 11 )   1549 - 1549   2008.11

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  • Urinary bladder and oesophageal temperatures correlate better in patients with high rather than low urinary flow rates during non-cardiac surgery

    H. Sato, M. Yamakage, K. Okuyama, Y. Imai, H. Iwashita, T. Ishiyama, T. Matsukawa

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   25 ( 10 )   805 - 809   2008.10

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  • 経皮的気管切開キットを用いた緊急気道確保 fresh cadaverによる検討

    関 忍, 杉野 繁一, 中山 雅康, 山内 正憲, 佐藤 順一, 山蔭 道明, 並木 昭義, 青木 光広, 鈴木 大輔, 辰巳 治之

    麻酔   57 ( 7 )   908 - 909   2008.7

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  • Reversal of neuromuscular blockade and complications of remaining blocking effect

    57 ( 7 )   838 - 844   2008.7

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  • 入室時の発作性心房細動のため手術延期となったが同日、緊急手術となった骨盤内臓全摘術の1症例

    澤田 敦史, 杉野 繁一, 福岡 英子, 山蔭 道明, 金谷 憲明, 並木 昭義

    北海道外科雑誌   53 ( 1 )   127 - 127   2008.6

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  • Isovolaemic haemodilution decreases the shivering threshold in rabbits

    Y. Imai, M. Yamakage, H. Sato, K. Okuyama, T. Ishiyama, T. Matsukawa

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   25 ( 6 )   450 - 453   2008.6

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  • 難治性心室性不整脈により体外循環離脱に難渋した1例

    澤田 敦史, 平田 直之, 山内 正憲, 山蔭 道明, 金谷 憲明, 並木 昭義

    北海道外科雑誌   53 ( 1 )   127 - 127   2008.6

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  • Effect of aging on the preoperative oxidative stress

    56 ( 12 )   1422 - 1424   2007.12

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  • 体外循環の離脱にMg2+の投与が有効であった一症例

    澤田 敦史, 平田 直之, 山蔭 道明, 山内 正憲, 並木 昭義

    麻酔と蘇生   43 ( 4 )   77 - 80   2007.12

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  • Work stress in medical anaesthesiology trainees

    M. Yamakage, T. Hayase, J. -I. Satoh, A. Namiki

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   24 ( 9 )   809 - 811   2007.9

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    DOI: 10.1017/S0265021507000282

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  • Pharmacological Features of Remifentanil

    YAMAKAGE Michiaki

    27 ( 4 )   369 - 380   2007.7

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  • ORナースのためのトピックス 超短時間作用性オピオイド鎮痛薬レミフェンタニル

    平田 直之, 山蔭 道明

    オペナーシング   22 ( 7 )   774 - 776   2007.7

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  • 心臓外科手術における超短時間作用性オピオイド鎮痛薬レミフェンタニルの有用性

    山蔭 道明, 平田 直之, 並木 昭義

    循環制御 = CIRCULATION CONTROL   28 ( 1 )   41 - 48   2007.3

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  • 超音波画像を用いて仙骨硬膜外カテーテルを挿入した1例

    樋口 美沙子, 山内 正憲, 中山 雅康, 杉野 繁一, 山蔭 道明, 並木 昭義

    臨床麻酔   31 ( 2 )   253 - 254   2007.2

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  • Regulation and Control of Body Temperature in the Elderly Patients and Detrimental Effect of Anesthesia

    YAMAKAGE Michiaki

    26 ( 2 )   29 - 34   2006.10

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  • デクスメデトミジンを用いて気道管理した気管ステント挿入術の1症例

    河村 真衣子, 杉野 繁一, 岩崎 創史, 山蔭 道明, 渡辺 廣昭, 並木 昭義

    日本臨床麻酔学会誌   26 ( 6 )   S302 - S302   2006.10

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  • 超音波画像を用いて仙骨硬膜外カテーテル挿入を施行した1例

    樋口 美沙子, 山内 正憲, 中山 雅康, 杉野 繁一, 山蔭 道明, 並木 昭義

    日本臨床麻酔学会誌   26 ( 6 )   S291 - S291   2006.10

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  • 電子麻酔記録を用いた麻酔診療評価の試み

    川口 亮一, 杉野 繁一, 山内 正憲, 山蔭 道明, 渡辺 廣昭, 明和 裕司, 並木 昭義

    日本臨床麻酔学会誌   26 ( 6 )   S413 - S413   2006.10

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  • Postoperative Analgesia by Continuous Epidural Infusion of Ropivacaine with Eptazocine after Abdominal Total Hysterectomy

    KON Hisako, YAMAKAGE Michiaki, FURUSE Shingo, NAGAI Soichiro, NAMIKI Akiyoshi

    26 ( 5 )   594 - 601   2006.9

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  • 麻酔科必修クリニカル・クラークシップに対する学生の評価と改善点

    山内 正憲, 山蔭 道明, 川股 知之, 新山 幸俊, 並木 昭義

    LiSA   13 ( 6 )   592 - 598   2006.6

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  • Preferable inotropic action of procaterol, a potent bronchodilator, on impaired diaphragmatic contractility in an intraabdominal septic model

    UZUKI MITSURU, YAMAKAGE MICHIAKI, FUJIMURA NAOYUKI, NAMIKI AKIYOSHI

    20 ( 2 )   145 - 148   2006.5

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  • 事例で学ぶ 実践!周術期の体温管理(第8回)体位と術式(2)大量出血手術

    平田 直之, 山蔭 道明

    オペナーシング   21 ( 5 )   521 - 525   2006.5

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    Other Link:: http://search.jamas.or.jp/link/ui/2006160472

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  • 事例で学ぶ 実践!周術期の体温管理(7)加温方法(2)輸液や手術野に使う液体の加温

    山内 正憲, 山蔭 道明

    オペナーシング   21 ( 3 )   322 - 324   2006.3

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  • Anandamide absorption by direct hemoperfusion with polymixin B-immobilized fiber improves the prognosis and organ failure assessment score in patients with sepsis

    KOHRO SHINJI, IMAIZUMI HITOSHI, YAMAKAGE MICHIAKI, MASUDA YOSHIKI, NAMIKI AKIYOSHI, ASAI YASUHUMI, MARUYAMA IKUO

    J Anesth   20 ( 1 )   11 - 16   2006.2

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  • 紹介 テオフィリン血中濃度簡易測定キット(アキュメータテオフィリン)の周術期管理における有用性

    岩崎 創史, 山蔭 道明, 佐藤 順一

    麻酔   54 ( 12 )   1385 - 1391   2005.12

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    Other Link:: http://search.jamas.or.jp/link/ui/2006103779

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  • 事例で学ぶ 実践!周術期の体温管理(3)全身麻酔による低体温

    平田 直之, 山蔭 道明

    オペナーシング   20 ( 11 )   1099 - 1102   2005.11

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  • 事例で学ぶ 実践!周術期の体温管理(第1回)術前の問題点とその対応

    山内 正憲, 山蔭 道明

    オペナーシング   20 ( 9 )   876 - 879   2005.9

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  • 吸入麻酔薬の作用機序に関する最近の知見

    山蔭 道明, 佐藤 順一, 岩崎 創史, 山内 正憲, 並木 昭義

    臨床麻酔   29 ( 8 )   1353 - 1356   2005.8

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  • Adequate shunt occlusion confirmed by near-infrared spectroscopy in a patient with arteriovenous malformation in the leg

    IWASAKI Sohshi, YAMAKAGE Michiaki, NAKAYAMA Masayasu, SATOH Jun-ichi, NAMIKI Akiyoshi

    19 ( 2 )   183 - 184   2005.5

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  • A trial of introduction of portfolio to elective clinical clerkship in anesthesiology

    Michiaki Yamakage, Hiroki Yamamoto, Shinji Kohro, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   54 ( 5 )   551 - 556   2005.5

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  • Intermittent pneumatic foot compression can activate blood fibrinolysis without changes in blood coagulability and platelet activation

    S Kohro, M Yamakage, K Sato, JI Sato, A Namiki

    ACTA ANAESTHESIOLOGICA SCANDINAVICA   49 ( 5 )   660 - 664   2005.5

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  • 紹介 麻酔科選択クリニカル・クラークシップへのポートフォリオ導入の試み

    山蔭 道明, 山本 浩貴, 佐藤 順一

    麻酔   54 ( 5 )   551 - 556   2005.5

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  • クロニジン前投与患者に発症した麻酔覚醒直後の腹痛症例

    岩崎 創史, 山蔭 道明, 渡辺 政徳, 山内 正憲, 浅野 真, 並木 昭義

    臨床麻酔   29 ( 5 )   846 - 848   2005.5

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  • Evaluation by undergraduate medical students of Clinical Clerkships in the Department of Anesthesiology - Comparison with the evaluation in previous fiscal year

    Michiaki Yamakage, Shinji Kohro, Hiroki Yamamoto, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   54 ( 5 )   541 - 550   2005.5

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  • Growth of Micro-organisms in Two Propofol Products at Room Temperature

    YAMAKAGE Michiaki, YAMAMOTO Hiroki, NAMIKI Akiyoshi

    25 ( 2 )   154 - 161   2005.3

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  • Variation of "pulse amplitude" measured bya pulse oximeter may help predict intravascular volume

    M Yamakage, T Itoh, SW Jeong, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   52 ( 2 )   207 - 208   2005.2

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  • The effect on body core temperature of abdominal skin disinfection with warmed povidone iodine products in patients for abdominal surgery

    OIKAWA Yoshihiro, ISHIKAWA Toyoko, YAMAKAGE Michiaki, NAMIKI Akiyoshi

    25 ( 4 )   275 - 280   2004.11

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  • Assessment of the quality of information on departments/divisions of anesthesiology available on the World Wide Web

    Michiaki Yamakage, Sei-Ichiro Ishiyama, Hiroki Yamamoto, Sohshi Iwasaki, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   53 ( 9 )   1069 - 1073   2004.9

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  • Inhibitory effects of the anesthetics propofol and sevoflurane on spontaneous lymphatic vessel activity in rats

    J Hattori, M Yamakage, S Seki, K Okazaki, A Namiki

    ANESTHESIOLOGY   101 ( 3 )   687 - 694   2004.9

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  • Evaluation by Undergraduate Medical Students of Clinical Clerkships in the Department of Anesthesiology

    Michiaki Yamakage, Hiroki Yamamoto, Sohshi Iwasaki, Masaki Toriyabe, Mitsuru Uzuki, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   53 ( 4 )   429 - 437   2004.4

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  • 紹介 麻酔科クリニカルクラークシップに対する学生の評価

    山蔭 道明, 山本 浩貴, 岩崎 創史

    麻酔   53 ( 4 )   429 - 437   2004.4

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  • The type of carbon dioxide absorbent has no relation to the concentration of carbon monoxide in the breathing circuit during low-flow isoflurane anaesthesia in smoking and non-smoking subjects

    M Yamakage, SI Yoshida, S Iwasaki, M Mizu-Uchi, A Namiki

    ANAESTHESIA AND INTENSIVE CARE   32 ( 2 )   230 - 235   2004.4

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  • Single-channel activity of L-type Ca2+ channels reconstituted with the beta(2c) subunit cloned from the rat heart

    Y Kamada, Y Yamada, M Yamakage, M Nagashima, M Tsutsuura, T Kobayashi, S Seki, A Namiki, N Tohse

    EUROPEAN JOURNAL OF PHARMACOLOGY   487 ( 1-3 )   37 - 45   2004.3

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  • Intravenous Fluid Administration and Management of Body Temperature

    Michiaki Yamakage, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   53 ( 1 )   10 - 22   2004.1

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  • Coronary Artery Spasm during Cholecystectomy with Pneumoperitoneum - A Case Report

    Soushi Iwasaki, Shingo Furuse, Masanori Watanabe, Masanori Yamauchi, Makoto Asano, Hitoshi Ooiwa, Michiaki Yamakage, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   53 ( 1 )   59 - 62   2004.1

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  • Guideline for basic techniques

    Manual for Residents in Anesthesiology   2004

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  • Anticoagulants and Antiplatelet agents

    J Clin Anesth (Jpn)   28   342 - 354   2004

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  • 基本手技ガイドライン

    必携麻酔科初期研修マニュアル   2004

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  • Medical gases and management of body temperature

    Handbook for operating theater   2004

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  • Effects of oral atenolol on volatile anesthetic induction with sevoflurane in adults

    Michiaki Yamakage, Hideaki Sasaki, Masahito Mizuuchi, Sohshi Iwasaki, Akiyoshi Namiki

    Journal of Anesthesia   18 ( 3 )   185 - 189   2004

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  • Safety and beneficial effect on the body core temperature of a prewarmed plasma substitute - Hydroxyethyl starch - During anesthesia

    Michiaki Yamakage, Hideaki Sasaki, Seong-Wook Jeong, Sohshi Iwasaki, Akiyoshi Namiki

    Journal of Anesthesia   18 ( 3 )   166 - 171   2004

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  • GVHD,水中毒,低体温・シバリング

    麻酔科診療プラクティス 第14巻   14   97 - 120   2004

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  • 麻酔の知識

    オペナーシング   19   394 - 400   2004

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  • 医療ガス,体温管理

    役に立つ手術室ハンドブック   2004

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  • GVHD

    Anesthesia Clinical Practice   14   97 - 120   2004

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  • Knowledge for Basic Anesthesia

    Openursing   19   394 - 400   2004

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  • 抗凝固薬と抗血小板薬

    臨床麻酔   28   342 - 354   2004

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  • 腹腔鏡下胆嚢摘出術中に冠動脈攣縮が顕在化した1症例

    岩崎 創史, 古瀬 晋吾, 渡辺 政徳

    麻酔   53 ( 1 )   59 - 62   2004

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  • 輸液と体温管理

    麻酔   53   10 - 22   2004

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  • 術中肺塞栓症を発症した反応性血小板増加症の麻酔経験

    吉田 真一郎, 紅露 伸司, 山蔭 道明

    麻酔   52 ( 12 )   1320 - 1322   2003.12

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  • A Case of Suspected Pulmonary Thrombosis in a Patient with Reactive Thrombocytemia Who Underwent Liver Subsegmentectomy

    Shin-Ichiro Yoshida, Shinji Kohro, Michiaki Yamakage, Masayasu Nakayama, Akiyoshi Namiki

    Japanese Journal of Anesthesiology   52 ( 12 )   1320 - 1322   2003.12

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  • The infusion rate of most disposable, non-electric infusion pumps decreases under hypobaric conditions

    M Mizuuchi, M Yamakage, S Iwasaki, A Kimura, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   50 ( 7 )   657 - 662   2003.8

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  • 電気メス使用時に極度の徐脈をきたしたペースメーカー埋め込み患者の1例

    岩崎 創史, 古瀬 晋吾, 渡辺 政徳, 山内 正憲, 浅野 真, 山蔭 道明, 並木 昭義

    北海道外科雑誌   48 ( 1 )   117 - 117   2003.6

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  • Repeated or prolonged isoflurane exposure reduces mitochondrial oxidizing effects

    S Kohro, QH Hogan, Y Nakae, M Yamakage, ZJ Bosnjak

    ANESTHESIOLOGY   98 ( 1 )   275 - 278   2003.1

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  • Anesthesia/Operation and Platelet/Coagulation Function

    J Clin Anesth (Jpn)   27   351 - 364   2003

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  • Preoperative evaluation and perioperative management of patients with pulmonary emphysema

    Life Support and Anesthesia   10   216 - 220   2003

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  • Keynote, iMovie, iDVD

    Nice presentation for everyone   2003

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  • Equipments for body temperature monitoring

    Perioperative monitoring equipments   2003

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  • Comparative study of the efficiency of four kinds of oxygen delivery system

    Can J Anaesth   50   1052 - 5   2003

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  • Recent aspects of medical education in Japan

    Sapporo Medical Journal   72   37 - 48   2003

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  • Anesthetic induction technique in adult

    Volatile induction and maintenance of anesthesia (VIMA) - Practice from Today -   2003

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  • Cellular mechanisms of airway smooth muscle relaxant effects of anesthetic agents

    Michiaki Yamakage, Akiyoshi Namiki

    Journal of Anesthesia   17 ( 4 )   251 - 258   2003

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  • Effects of intermittent pneumatic foot compression on blood coagulability and fibrinolysis assessed by a whole blood viscometer Sonoclot

    Shinji Kohro, Michiaki Yamakage, Toshiyuki Takahashi, Koichi Ota, Mitsu Kondo, Akiyoshi Namiki

    Journal of Anesthesia   17 ( 3 )   208 - 210   2003

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  • Deep temperature monitoring using a zero-heat-flow method

    Michiaki Yamakage, Akiyoshi Namiki

    Journal of Anesthesia   17 ( 2 )   108 - 115   2003

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    DOI: 10.1007/s005400300026

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  • 最近の医学教育の変遷と動向

    札幌医学雑誌   72   37 - 48   2003

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  • ペースメーカと麻酔

    Life Support and Anesthesia   10   750 - 753   2003

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  • 麻酔・手術と血小板・血液凝固能

    臨床麻酔   27   351 - 364   2003

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  • 成人の導入法の工夫

    今日から実践できるVIMA   2003

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  • Cardiac pacemaker and Anesthesia

    Life Support and Anesthesia   10   750 - 753   2003

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  • 肺気腫患者の術前評価と管理

    Life Support and Anesthesia   10   216 - 220   2003

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  • 体温のモニター機器

    周術期管理に役立つ臨床モニター機器の知識と使い方   2003

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  • 周術期体温に関する基礎知識

    山蔭 道明

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia   22 ( 8 )   S130 - S131   2002.9

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  • Prophylactic IM small-dose phenylephrine blunts spinal anesthesia-induced hypotensive response during surgical repair of hip fracture in the elderly

    K Nishikawa, M Yamakage, K Omote, A Namiki

    ANESTHESIA AND ANALGESIA   95 ( 3 )   751 - 756   2002.9

  • Inhibitory effects of volatile anesthetics on currents produced on heterologous expresssion of KvLQT1 and minK in Xenopus oocytes

    XD Chen, M Yamakage, Y Yamada, N Tohse, A Namiki

    VASCULAR PHARMACOLOGY   39 ( 1-2 )   33 - 38   2002.7

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  • A truncated splice variant of KCNQ1 cloned from rat heart

    Y Yamada, XD Chen, T Kobayashi, Y Kamada, M Nagashima, M Tsutsuura, S Seki, M Yamakage, A Namiki, N Tohse

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   294 ( 2 )   199 - 204   2002.6

  • Editorial II - Effects of anaesthetic agents on airway smooth muscles

    M Yamakage

    BRITISH JOURNAL OF ANAESTHESIA   88 ( 5 )   624 - U2   2002.5

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  • Calcium channels - basic aspects of their structure, function and gene encoding; anesthetic action on the channels - a review

    M Yamakage, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   49 ( 2 )   151 - 164   2002.2

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  • Intermittent pneumatic compression prevents venous stasis in the lower extremities in the lithotomy position

    S Kohro, M Yamakage, T Takahashi, M Kondo, K Ota, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   49 ( 2 )   144 - 147   2002.2

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  • Inhibitory effects of volatile anesthetics on K+ and Cl- channel currents in porcine tracheal and bronchial smooth muscle

    XD Chen, M Yamakage, A Namiki

    ANESTHESIOLOGY   96 ( 2 )   458 - 466   2002.2

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  • The repolarizing effects of volatile anesthetics on porcine tracheal and bronchial smooth muscle cells

    M Yamakage, XD Chen, A Kimura, S Iwasaki, A Namiki

    ANESTHESIA AND ANALGESIA   94 ( 1 )   84 - 88   2002.1

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  • Sevoflurane inhibits contraction of uterine smooth muscle from pregnant rats similarly to halothane and isoflurane

    M Yamakage, N Tsujiguchi, XD Chen, Y Kamada, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   49 ( 1 )   62 - 66   2002.1

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  • A case report of inflammatory pseudotomors of the liver and spleen

    Anesth Resus   38   61 - 63   2002

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  • たばこにまつわる問題点

    臨床麻酔   24   641 - 651   2002

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  • Respiratory diseases

    Anesthesiologists and Consultation   2002

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  • Evaluation of four techniques of warming intravenous fluids

    Naomi Ohtsuka, Michiaki Yamakage, Xiangdong Chen, Yasuhiro Kamada, Akiyoshi Namiki

    Journal of Anesthesia   16 ( 2 )   145 - 149   2002

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  • 妊娠初期・後期患者の非産科手術の麻酔

    麻酔科診療プラクティス   2002

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  • Non-obstetric anesthesia during pregnancy

    Practice in Clinical Anesthesia   2002

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  • Topics related to tabacco

    YAMAKAGE M

    J Clin Anesth (Jpn)   24   641 - 651   2002

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  • Body temperature management

    J Clin Anesth (Jpn)   26   1681 - 1692   2002

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  • Nitrous oxide

    Medical Gases and risk management   2002

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  • Evaluation of a newly developed monitor of deep body temperature

    Michiaki Yamakage, Sohshi Iwasaki, Akiyoshi Namiki

    Journal of Anesthesia   16 ( 4 )   354 - 357   2002

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    DOI: 10.1007/s005400200056

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  • Usefulness of oral hypnotic premedication for volatile induction of anesthesia in adults

    Michiaki Yamakage, Shigeo Tsuchiya, Naomi Ohtsuka, Sohshi Iwasaki, Akiyoshi Namiki

    Journal of Anesthesia   16 ( 3 )   194 - 197   2002

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    DOI: 10.1007/s005400200023

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  • 自験例からみた体温管理

    臨床麻酔   26   1681 - 1692   2002

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  • 呼吸器系疾患

    麻酔科医とコンサルテーション   2002

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  • 医療ガス−用途とその作用・管理法−.5.亜酸化窒素

    日常診療に役立つ医療ガスと危機管理   2002

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  • Anesthetic effects on mitochondrial ATP-sensitive K channel

    S Kohro, QH Hogan, Y Nakae, M Yamakage, ZJ Bosnjak

    ANESTHESIOLOGY   95 ( 6 )   1435 - 1440   2001.12

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  • Evaluation of Anesthetic Techniques used in Laparoscopic Cholecystectomy

    TSUJIGUCHI Naoki, YAMAKAGE Michiaki, KOTAKI Masatoshi, NAMIKI Akiyoshi

    21 ( 9 )   409 - 415   2001.11

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  • Mechanisms of direct inhibitory action of propofol on uterine smooth muscle contraction in pregnant rats

    N Tsujiguchi, M Yamakage, A Namiki

    ANESTHESIOLOGY   95 ( 5 )   1245 - 1255   2001.11

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  • Use of the fibreoptic stylet scope (Styletscope (TM)) reduces the hemodynamic response to intubation in normotensive and hypertensive patients

    A Kimura, M Yamakage, XD Chen, Y Kamada, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   48 ( 9 )   919 - 923   2001.10

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  • Production of compound A under low-flow anesthesia is affected by type of anesthetic machine

    M Yamakage, A Kimura, XD Chen, N Tsujiguchi, Y Kamada, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   48 ( 5 )   435 - 438   2001.5

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  • Different inhibitory effects of volatile anesthetics on T- and L-type voltage-dependent Ca2+ channels in porcine tracheal and bronchial smooth muscles

    M Yamakage, XD Chen, N Tsujiguchi, Y Kamada, A Namiki

    ANESTHESIOLOGY   94 ( 4 )   683 - 693   2001.4

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  • Effects of volatile anesthetics on airway/bronchus

    Anet   5   3 - 7   2001

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  • 肺梗塞,気胸・胸水

    麻酔科診療プラクティス第2巻「麻酔科専門医に必要な画像診断」   2001

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  • Celite-activated viscometer Sonoclot can measure the suppressive effect of tranexamic acid on hyperfibrinolysis in cardiac surgery

    K. Kamada, M. Yamakage, T. Niiya, N. Tsujiguchi, X. Chen, A. Namiki

    Journal of Anesthesia   15 ( 1 )   17 - 21   2001

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    DOI: 10.1007/s005400170046

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  • Human genomics and anesthesiology

    J Clin Anesth (Jpn)   25   1597 - 1603   2001

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  • Evaluation of respiratory function

    How to of Anesthesia - Diagnosis version -   2001

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  • 吸入麻酔薬が気管支に及ぼす影響

    Anet   5   3 - 7   2001

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  • セボフルランを用いた低流量麻酔(LFA)と単一吸入麻酔薬による麻酔導入維持法(VIMA)

    麻酔と蘇生   37   61 - 68   2001

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  • 無理のない低流量麻酔の実際(新鮮ガス流量1L/min程度まで)

    今日から実践できる低流量麻酔   2001

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  • Usefulness of midazolam premedication for volatile induction of anesthesia in adults

    J. I. Hattori, M. Yamakage, S. Iwasaki, X. Chen, N. Tsujiguchi, A. Namiki

    Journal of Anesthesia   15 ( 2 )   117 - 119   2001

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    DOI: 10.1007/s005400170041

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  • ヒトゲノムと麻酔科学

    臨床麻酔   25   1597 - 1603   2001

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  • Low Flow Anesthesia (>1 L/min)

    Low Flow Anesthesia   2001

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  • Pulmonary embolism and Pneumothorax

    Clinical Practice of Anesthesia, Vol. 2   2001

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  • Comparative survey of cardiac arrests during anesthesia and surgery in the 1980s and 1999s

    S. Iwasaki, M. Yamakage, K. Nishikawa, X. Chen, A. Namiki

    Japanese Journal of Anesthesiology   50 ( 2 )   136 - 143   2001

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  • Changes in sedative level during induction of anesthesia using a single volatile anesthetic

    M. Yamakage, X. Chen, Y. Kamada, N. Tsujiguchi, A. Namiki

    Japanese Journal of Anesthesiology   50 ( 4 )   383 - 386   2001

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  • Guidelines of sedation and analgesia for non-anesthesiologists

    Techniques of Sedation and Analgesia for Examination and Minor Surgery   2001

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  • 呼吸機能の評価

    麻酔のHow To−診断編−   2001

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  • 非麻酔専門医による鎮静・鎮痛法ガイドライン

    検査・小手術の鎮静法と鎮痛法   2001

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  • Low flow anesthesia with sevoflurane and volatile induction and maintenance of anesthesia

    YAMAKAGE M

    Anesth Resus   37   61 - 68   2001

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  • 成人の体温管理 : 開心術症例の特徴

    山蔭 道明

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia   20 ( 8 )   S212   2000.9

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  • Interaction between volatile anesthetics and hypoxia in porcine tracheal smooth muscle

    M Yamakage, XD Chen, N Tsujiguchi, Y Kamada, A Namiki

    ANESTHESIOLOGY   93 ( 3A )   U234 - U234   2000.9

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  • Carbon dioxide absorbents containing KOH/NaOH produce much higher concentrations of compound A from sevoflurane in clinical practice

    M Yamakage, S Yamada, XD Chen, S Iwasaki, A Namiki

    ANESTHESIOLOGY   93 ( 3A )   U225 - U225   2000.9

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  • Different inhibitory effects of volatile anesthetics on T- and L-type calcium channels in airway smooth muscle

    M Yamakage, XD Chen, N Tsujiguchi, Y Kamada, A Namiki

    ANESTHESIOLOGY   93 ( 3A )   U234 - U234   2000.9

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  • Estimation of the Analgesic Level of Spinal Anesthesia by Measuring the Skin Temperature Using an Infrared Thermometer

    ITOH Yukiyo, YAMAKAGE Michiaki, NAKAYAMA Yoshito, KAMADA Yasuhiro, CHEN Xiangdong, NAMIKI Akiyoshi

    20 ( 6 )   372 - 375   2000.7

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  • Carbon dioxide absorbents containing potassium hydroxide produce much larger concentrations of compound A from sevoflurane in clinical practice

    M Yamakage, S Yamada, XD Chen, S Iwasaki, N Tsujiguchi, A Namiki

    ANESTHESIA AND ANALGESIA   91 ( 1 )   220 - 224   2000.7

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  • Low-temperature modification of the inhibitory effects of volatile anesthetics on airway smooth muscle contraction in dogs

    N Yamakage, N Tsujiguchi, J Hattori, Y Kamada, A Namiki

    ANESTHESIOLOGY   93 ( 1 )   179 - 188   2000.7

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  • Modified simple technique of anesthetic induction in adults by administering sevoflurane via the face mask

    M Yamakage, J Hattori, Y Kamada, N Tsujiguchi, A Namiki

    ANESTHESIA AND ANALGESIA   90 ( 2 )   2000.2

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  • The usefulness of celite-activated thromboelastography (sonoclot (TM)) in cardiac surgery for evaluating fibrinolyctic status

    M Yamakage, Y Kamada, T Niiya, S Kohro, A Namiki

    ANESTHESIA AND ANALGESIA   90 ( 2 )   U76 - U76   2000.2

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  • Predictive variables of hypothermia in the early phase of general anesthesia

    M Yamakage, Y Kamada, Y Honma, N Tsujiguchi, A Namiki

    ANESTHESIA AND ANALGESIA   90 ( 2 )   456 - 459   2000.2

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  • 統計学の意味

    図解−やさしい統計学と図表・スライドの作り方   2000

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  • General anesthesia with epidural block and control of body temperature

    J Clin Anesth (Jpn)   24   1416 - 1424   2000

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  • Meaning of Statistics

    Basic Statistics and How to Make Figures and Slides   2000

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  • Preoperative evaluation

    Expert Nursing for Management of Anesthesia in Operating Rooms   2000

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  • Anesthetic management of a patient with Freeman-Sheldon syndrome

    M. Namiki, T. Kawamata, M. Yamakage, A. Matsuno, A. Namiki

    Japanese Journal of Anesthesiology   49 ( 8 )   901 - 902   2000

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  • 麻酔の申し込み,麻酔前診察

    手術室における麻酔・全身管理エキスパートナーシング   2000

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  • 硬膜外麻酔併用全身麻酔と体温調節

    臨床麻酔   24   1416 - 1424   2000

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  • Volatile anesthetics inhibit voltage-dependent Ca2+channels in the myometrium from pregnant rats

    M Yamakage, M Watanabe, J Hattori, Y Kamada, A Namiki

    ANESTHESIOLOGY   91 ( 3A )   U443 - U443   1999.9

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  • Direct inhibitory effect of intravenous anesthetics on the myometrium of pregnant rats

    N Tsujiguchi, M Yamakage, Y Kamada, J Hattori, A Namiki

    ANESTHESIOLOGY   91 ( 3A )   U442 - U442   1999.9

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  • The predictive parameters of hypothermia in the early phase of general anesthesia

    M Yamakage, Y Kamada, Y Honma, N Tsujiguchi, A Namiki

    ANESTHESIOLOGY   91 ( 3A )   U265 - U265   1999.9

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  • Direct effects of adrenergic stimulus on the CA2+and K+ channel activities of dorsal root ganglion neurons in a rat neuropathic pain model

    Y Honma, M Yamakage, A Namiki

    ANESTHESIOLOGY   91 ( 3A )   U381 - U381   1999.9

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  • Changes in respiratory pattern and arterial blood gases during sedation with propofol or midazolam in spinal anesthesia

    M Yamakage, Y Kamada, M Toriyabe, Y Honma, A Namiki

    JOURNAL OF CLINICAL ANESTHESIA   11 ( 5 )   375 - 379   1999.8

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  • 健常者ならびに全身麻酔症例での安全で効果的な電気敷布の設定方法

    川端 ルミ, 伊東 琴絵, 平野 裕子, 堀内 千尋, 山内 正憲, 山蔭 道明, 並木 昭義

    臨床体温   17 ( 1 )   49 - 53   1999.8

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  • The direct effects of heparin and protamine on canine tracheal smooth muscle tone

    M Yamakage, T Matsuzaki, N Tsujiguchi, T Mori, A Namiki

    ANESTHESIA AND ANALGESIA   88 ( 6 )   1232 - 1238   1999.6

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  • Effects of adrenergic stimulus on the activities of Ca2+ and K+ channels of dorsal root ganglion neurons in a neuropathic pain model

    Y Honma, M Yamakage, T Ninomiya

    BRAIN RESEARCH   832 ( 1-2 )   195 - 206   1999.6

  • In vitro effects of propofol on blood coagulability and fibrinolysis by the use of thromboelastograph technique

    S Kohro, M Yamakage, T Omote, A Namiki

    ACTA ANAESTHESIOLOGICA SCANDINAVICA   43 ( 2 )   217 - 219   1999.2

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  • Does sevoflurane anesthesia shorten vecuronium muscle relaxation during induction?

    H Tsuchida, M Yamakage, H Iwasaki, A Matsuno, A Namiki

    ANESTHESIA AND ANALGESIA   88 ( 2 )   U45 - U45   1999.2

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  • Circulatory response to endotracheal intubation after propofol induction - Comparative study of fentanyl with nitrous oxide sevoflurane anesthesia

    H Tsuchida, A Matsuno, H Iwasaki, M Yamakage, A Namiki

    ANESTHESIA AND ANALGESIA   88 ( 2 )   U78 - U78   1999.2

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  • Inhibitory effects of diazepam and midazolam on Ca2+ and K+ channels in canine tracheal smooth muscle cells

    M Yamakage, T Matsuzaki, N Tsujiguchi, Y Honma, A Namiki

    ANESTHESIOLOGY   90 ( 1 )   197 - 207   1999.1

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  • 術中体温管理のポイント

    オペナーシング   14   33 - 37   1999

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  • Mechanisms of contraction and relaxation of airway smooth muscle

    Anesthesiologists and Basic Research - Muscle contraction/relaxation and anesthetics   1999

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  • Points of intraoperative management of body temperature

    Ope Nursing   14   33 - 37   1999

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  • 気道平滑筋の収縮・弛緩機構

    麻酔科医と基礎研究「筋の収縮・弛緩と麻酔薬」   1999

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  • MAC

    Volatile Anesthetic Sevofrane   1999

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  • The usefulness of celite-activated thromboelastography for evaluation of fibrinolysis

    M Yamakage, N Tsujiguchi, S Kohro, H Tsuchida, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   45 ( 10 )   993 - 996   1998.10

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  • Formalin-induced releases of glutamate and nitric oxide, and their relationship in the skin of the rat hindpaw

    K Omote, T Kawamata, M Kawamata, M Yamakage, E Narimatsu, A Namiki

    ANESTHESIOLOGY   89 ( 3A )   U723 - U723   1998.9

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  • Inhibitory effect of noradrenalin on voltage-dependent Ca2+ channels of rat sensory neurons in neuropathic pain model

    Y Honma, M Yamakage, A Namiki

    ANESTHESIOLOGY   89 ( 3A )   U934 - U934   1998.9

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  • Low-temperature modification of the inhibitory effect of halothane on airway smooth muscle contraction in dogs

    M Yamakage, N Tsujiguchi, T Mori, T Matsuzaki, A Namiki

    ANESTHESIOLOGY   89 ( 3A )   U1054 - U1054   1998.9

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  • Inhibitory effects of halothane, isoflurane, and sevoflurane on contractility and intracellular Ca2+ concentration of pregnant myometrium in rats

    M Yamakage, T Mori, N Tsujiguchi, S Kawana, A Namiki

    ANESTHESIOLOGY   89 ( 3A )   U881 - U881   1998.9

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  • 小児前投薬のアトロピンとミダゾラムが体温に与える影響

    土田 亜矢, 山内 正憲, 山蔭 道明, 並木 昭義

    臨床体温   16 ( 1 )   45 - 49   1998.8

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  • Role of intracellular Ca2+ stores in the inhibitory effect of halothane on airway smooth muscle contraction

    M Yamakage, S Kohro, T Matsuzaki, H Tsuchida, A Namiki

    ANESTHESIOLOGY   89 ( 1 )   165 - 173   1998.7

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  • 急速輸液の中枢温の及ぼす影響と輸液加温装置の有用性

    山内 正憲, 中山 禎人, 山蔭 道明

    麻酔   47 ( 5 )   606 - 610   1998.5

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  • Surgical/tourniquet pain accelerates blood coagulability but not fibrinolysis

    S Kohro, M Yamakage, J Arakawa, M Kotaki, T Omote, A Namiki

    BRITISH JOURNAL OF ANAESTHESIA   80 ( 4 )   460 - 463   1998.4

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  • Triggering delay time and work of breathing in three paediatric patient-triggered ventilators

    Y Nakae, M Yamakage, M Aimono, K Tamiya, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   45 ( 3 )   261 - 265   1998.3

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  • Effect of recycled autologous blood transfusion on in vitro blood coagulability and fibrinolysis

    T Takeda, S Kohro, M Yamakage, N Tsujiguchi, H Tsuchida, A Namiki

    ANESTHESIA AND ANALGESIA   86 ( 2S )   U79 - U79   1998.2

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  • The effect of scalp infiltration with bupivacaine on blood coagulability and fibrinolysis in neurovascular surgery

    N Tsujiguchi, S Kohro, M Yamakage, J Arakawa, T Omote, A Namiki

    ANESTHESIA AND ANALGESIA   86 ( 2S )   U219 - U219   1998.2

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  • Effects of propofol on common bile duct pressure in the canine choledochoduodenal junction

    H Iwasaki, H Tsuchida, K Omote, M Yamakage, A Namiki

    ANESTHESIA AND ANALGESIA   86 ( 2S )   U282 - U282   1998.2

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  • A questionnaire survey on the discontinuance of cardiopulmonary resuscitation.

    Namiki Akiyoshi, Arai Tatsuru, Amaha Keisuke, Shigematsu Akio, Suzuki Masahiro, Horikawa Hideo, Ujike Yoshito, Omote Tetsuo, Imaizumi Hitoshi, Yamakage Michiaki

    Japanese Journal of Reanimatology   17 ( 2 )   87 - 107   1998

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    We sent out questionnaires on the timing and condition for the discontinuation of cardiopulmonary resuscitation (CPR) in cardiac arrest patients to 392 elder members of the Japanese Society of Reanimatology, Japan Society of Intensive Care Medicine and Japan Society of Anesthesiology, and received 229 replies (58.4%) . The results were as follows: Important factors in the decision of discontinuation of CPR were, 1) whether the cardiac arrest occurred more than 30 min before the start of CPR, 2) cardiac standstill on ECG, 3) terminal stage of cancer, and 4) massive traumatic injury including burn. The most respondents usually performed CPR for about 30 min in cases where the cardiac arrest occurred less than 30 min prior to initiation of CPR, but the CPR time is extended to over 1 h in previously healthy victims, victims under 15 y/o, arresting time less than 5 min, hypothermia of 25°C or less, and in victims without history of critical basic disorders. If closed chest CPR is not effective, 46% of respondents are willing to perform open chest CPR and 28% cardiopulmonary bypass procedure. The respondents requested our committee to produce a manual for the discontinuance of CPR. At present, it is not feasible for our committee to make the manual, but we are planning to make a guideline.

    DOI: 10.11414/jjreanimatology1983.17.87

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  • Effects of anesthetics on platelet function and perioperative changes in blood coagulability/fibrinolysis

    J Clin Anesth (Jpn)   22   1371 - 1382   1998

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  • Symbols and abbreviations used for artificial respiratory management

    Textbook of artificial respiratory management   1998

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  • Asthma

    Emergency of anesthesia, Vol. 2   1998

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  • Basic knowledge of management of body temperature

    Basics of management of body temperature   1998

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  • Pitfall of anesthesia for thoracic aortic aneurysm

    J Clin Anesth (Jpn)   22   347 - 351   1998

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  • 喘息−周術期での喘息発作に対する対応

    麻酔緊急「あなたならどうする」のコツとポイントVol. 2   1998

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  • 体温管理の基礎知識

    図解−体温管理入門   1998

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  • 胸部大動脈瘤麻酔のピットフォール

    臨床麻酔   22   347 - 351   1998

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  • 麻酔薬の血小板機能に及ぼす影響と周術期の血液凝固線溶能の変化

    臨床麻酔   22   1371 - 1382   1998

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  • 人工呼吸管理で使用される記号,略語とその解説

    よくわかる人工呼吸管理テキスト   1998

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  • Onset of vecuronium neuromuscular blockade at the hand with an arterio-venous shunt

    H Iwasaki, M Yamauchi, E Narimatsu, M Yamakage, H Tsuchida, A Namiki

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   44 ( 11 )   1208 - 1210   1997.11

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  • The effects of propofol on blood coagulability and fibrinolysis by the use of thromboelastogram technique

    S Kohro, J Arakawa, T Omote, M Yamakage, A Namiki

    ANESTHESIOLOGY   87 ( 3 )   A335 - A335   1997.9

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  • The inhibitory effects of benzodiazepines on voltage-dependent Ca2+ and K+ channels in canine tracheal smooth muscle cells

    M Yamakage, T Matsuzaki, Y Honma, H Iwasaki, A Namiki

    ANESTHESIOLOGY   87 ( 3 )   A1115 - A1115   1997.9

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  • 脊椎麻酔下での経尿道的手術におけるWarm TouchTMの加温効果

    岡崎 加代子, 山内 正憲, 山蔭 道明

    臨床体温   15 ( 1 )   39 - 43   1997.9

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    Ichushi

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  • 二重チューブ式血液・輸液加温装置(HOT LINETM)の使用経験

    山内 正憲, 中山 禎人, 山蔭 道明

    臨床体温   15 ( 1 )   18 - 22   1997.9

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    Ichushi

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  • Effects of heparin and protamine on canine tracheal smooth muscle contractility and intracellular Ca2+

    T Matsuzaki, M Yamakage, Y Honma, H Tsuchida, A Namiki

    ANESTHESIOLOGY   87 ( 3 )   A1085 - A1085   1997.9

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  • Prospective Study of the Effects of Repeated Sevoflurane Anesthesia on Hepatic and Renal Function

    YAMAKAGE Michiaki, SEKI Sumihiko, SATOH Osamu, OHMORI Hideya, IWASAKI Hiroshi, NAMIKI Akiyoshi

    17 ( 6 )   378 - 383   1997.7

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  • Inhibition of voltage-dependent Ca2+ channels of porcine tracheal smooth muscle by the novel Ca2+ channel antagonist RWJ-22108

    M Yamakage, CA Hirshman, A Namiki, TL Croxton

    GENERAL PHARMACOLOGY   28 ( 5 )   689 - 694   1997.5

  • Onset of vecuronium and pancuronium neuromuscular block with and without severe cardiac valvular disease

    H Iwasaki, M Yamauchi, H Tsuchida, M Yamakage, H Ohmori, A Namiki

    ANESTHESIA AND ANALGESIA   84   S503 - S503   1997.2

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  • The relationship between respiratory patterns and work of breathing during halothane anesthesia with spontaneous ventilation

    M Yamakage, S Kohro, Y Honma, M Edanaga, M Okanuma, A Namiki

    ANESTHESIA AND ANALGESIA   84   S599 - S599   1997.2

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  • Thromboelastogram showing an undesirable effect of platelet transfusion on blood coagulability and fibrinolysis in a patient with aplastic anemia

    S. Kohro, M. Yamakage, T. Takeda, A. Namiki

    Journal of Anesthesia   11 ( 4 )   303 - 306   1997

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    DOI: 10.1007/BF02480749

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  • Role of intracellular Ca2+ stores in the inhibitory effect of halothane on airway smooth muscle contraction

    M Yamakage, S Kohro, A Namiki

    ANESTHESIOLOGY   85 ( 3A )   A1128 - A1128   1996.9

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  • EFFECTS OF HALOTHANE ON INTRACELLULAR CA2+ REGULATORY SYSTEMS IN HUMAN PLATELET

    S KOHRO, M YAMAKAGE, A NAMIKI

    ANESTHESIOLOGY   83 ( 3A )   A309 - A309   1995.9

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  • INHIBITION OF VOLTAGE-DEPENDENT CA2+ CHANNELS IN PORCINE TRACHEAL SMOOTH-MUSCLE BY KETAMINE, PROPOFOL, AND THIOPENTAL

    M YAMAKAGE, TL CROXTON, CA HIRSHMAN

    ANESTHESIOLOGY   83 ( 3A )   A1203 - A1203   1995.9

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  • Patch clamp techniques to study effects of anesthetics on airway smooth muscle cells

    YAMAKAGE Michiaki, CROXTON Thomas, HIRSHMAN Carol A

    J Anesth   9 ( 1 )   111 - 112   1995.2

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  • THE EFFECTS OF EXTRACELLULAR PH ON INTRACELLULAR PH, CA2+ AND TENSION OF CANINE TRACHEAL SMOOTH-MUSCLE STRIPS

    M YAMAKAGE, S KOHRO, M YAMAUCHI, A NAMIKI

    LIFE SCIENCES   56 ( 8 )   PL175 - PL180   1995.1

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  • 腹部大動脈瘤および閉塞性動脈硬化症の人工血管置換術における足底深部温の変化

    山内 正憲, 山蔭 道明, 其田 一

    臨床体温   14 ( 2 )   51 - 55   1994.12

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    Ichushi

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  • INHIBITION BY HALOTHANE OF VOLTAGE-DEPENDENT CA2+ CURRENTS IN PORCINE TRACHEAL SMOOTH-MUSCLE CELLS

    M YAMAKAGE, TL CROXTON, CA HIRSHMAN

    ANESTHESIOLOGY   81 ( 3A )   A1445 - A1445   1994.9

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  • DIRECT INHIBITORY MECHANISMS OF HALOTHANE ON HUMAN PLATELET-AGGREGATION

    S KOHRO, M YAMAKAGE, A NAMIKI

    ANESTHESIOLOGY   81 ( 3A )   A442 - A442   1994.9

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  • 平滑筋に対する吸入麻酔薬の直接作用機序

    山蔭 道明, 土田 英昭, 並木 昭義

    麻酔   42 ( 11 )   p1578 - 1586   1993.11

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    Other Link:: http://search.jamas.or.jp/link/ui/1994111266

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  • INHIBITORY EFFECTS OF HALOTHANE ON HIGH K+-INDUCED CANINE TRACHEAL SMOOTH-MUSCLE CONTRACTION AND INTRACELLULAR CA2+

    M YAMAKAGE, T KAWAMATA, S KOHRO, A NAMIKI

    ANESTHESIOLOGY   79 ( 3A )   A1207 - A1207   1993.9

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  • EFFECTS OF ACIDOSIS AND HYPOXIA ON THE CONTRACTILITY OF CANINE TRACHEAL SMOOTH-MUSCLE - ROLE OF INTRACELLULAR CA2+ AND PH

    M YAMAKAGE, T KAWAMATA, S KOHRO, A NAMIKI

    ANESTHESIOLOGY   79 ( 3A )   A1208 - A1208   1993.9

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  • Mechanisms of action of volatile anesthetics on smooth muscle

    M. Yamakage, H. Tsuchida, A. Namiki

    Japanese Journal of Anesthesiology   42 ( 11 )   1578 - 1586   1993

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    PubMed

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  • Prospective Study of Factors Leading to Fall in Body Temperature During Operation in Extensively Burned Patients.

    YAMAKAGE Michiaki, YOSHIDA Izumi, KAWAMATA Tomoyuki, YAMAUCHI Masanori, NAMIKI Akiyoshi

    J.J.S.C.A   13 ( 6 )   548 - 554   1993

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    Language:Japanese   Publisher:THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA  

    We investigated factors leading to fall in body temperature during surgery in five extensively burned patients (burn index&gt;30), prospectively. The difference in the temperatures at the beginning and the end of the operation was regarded as the &quot;temperature gradient&quot;. There was no significant correlation between the temperature gradient and burn index, duration of anesthesia or operation, amount of blood loss or transfusion, or operating area. The temperature gradient of the GOI (nitrous oxide+oxygen+isoflurane) group (-1.48&amp;plusmn;0.58(mean&amp;plusmn;SD)&amp;deg;C, n=10) was significantly lower than that of the GO+KM (GO+ketamine+midazolam) group (-0.80&amp;plusmn;0.30&amp;deg;C, n=16) (P&lt;0.01). The temperature gradient of the group in prone position (-1.91&amp;plusmn;0.31&amp;deg;C, n=14) was significantly lower than that of the group in supine position (-0.08&amp;plusmn;0.34&amp;deg;, n=12) (P=0.001). For the intraoperative management of body temperature in exten-sively burned patients, we recommend Ketamine rather than inhalational anesthetics, and that the duration of skin sterilization, especially in patients in prone position, be shortened.

    DOI: 10.2199/jjsca.13.548

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  • 三尖弁閉鎖不全を合併した拘束型心筋症の開心術麻酔経験

    山内 正憲, 山蔭 道明, 土田 英昭

    臨床麻酔   16 ( 7 )   919 - 920   1992.7

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    Ichushi

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Awards

  • 北海道麻酔科学会 第16回高橋賞

    2003  

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  • Takahashi Prize of Hokkaido Society of Anesthesiologiists

    2003  

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  • 日本麻酔科学会 第21回山村記念賞

    2002  

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  • Yamamura Memorial Prize, Japan Society of Anesthesiologists

    2002  

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  • 上原記念財団奨励研究

    2000  

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  • The Uehara Memorial Foundation, Incentive Grant

    2000  

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  • Japan Society for the Promotion of Science (JSPS) Postdoctoral Fellowship for Research Abroad

    1994  

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  • 日本学術振興会海外特別研究員

    1994  

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Research Projects

  • 低親和性神経成長因子受容体選択的リガンド:LM11A-31による術後認知機能障害予防戦略

    Grant number:23K08411  2023.4 - 2026.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    山蔭 道明, 平畑 知輝, 茶木 友浩, 佐藤 慧

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    Grant amount:\4680000 ( Direct Cost: \3600000 、 Indirect Cost:\1080000 )

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  • 人工呼吸器関連肺障害における肺血管内皮グリコカリックスの動態と新たな治療法の探索

    Grant number:22K09123  2022.4 - 2025.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    菊池 謙一郎, 数馬 聡, 山蔭 道明

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    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

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  • Prevention strategies for perioperative neuroinflammation related diseases with a focus on stabilization of intestinal microbiota

    Grant number:19K09331  2019.4 - 2022.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    Yamakage Michiaki

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    Grant amount:\4290000 ( Direct Cost: \3300000 、 Indirect Cost:\990000 )

    In a metagenomic analysis of cecal contents collected under anesthesia after surgical intervention, we were unable to explore significant changes between the groups. It was suggested that the timeline of intervention and other factors need to be re-examined. While the composition of the cecal contents was not acutely altered, we did find changes in delirium behavior in the surgical group, with no significant differences between groups. Additional experiments are planned.
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    Translated with www.DeepL.com/Translator (free version)

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  • Analysis of a relationship between postoperative delirium or/and cognitive dysfunction and aging by transcriptome analysis

    Grant number:16K10967  2016.4 - 2019.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    Yamakage Michiaki, TACHIBANA SHUNSUKE

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    Grant amount:\4290000 ( Direct Cost: \3300000 、 Indirect Cost:\990000 )

    Transcriptome analysis revealed that age differences resulted in significant changes in gene expression in the hippocampus after anesthesia and surgery. In other words, it was suggested that metabolisms and reactivities in the brain cause differences in responses due to aging.
    In addition, the sensitivity of anesthetics due to aging and the immune response to surgical insult are different, and the possibility of clarifying the mechanism of influences and differences in brain function was shown.

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  • Living with chronic non-cancer pain receiving opioid therapy

    Grant number:15K11575  2015.4 - 2019.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    SHINDO Yukari, Yamakage Michiaki, Watanabe Akihiko

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    Grant amount:\4420000 ( Direct Cost: \3400000 、 Indirect Cost:\1020000 )

    Narratives of daily life of outpatients in Japan receiving opioid therapy for chronic non-cancer pain were obtained to identify health problems and barriers to obtaining a high quality of life. Participants were 34 adult volunteer outpatients treated in pain clinics. Data were collected using semi-structured interviews and analyzed through grounded theory. Participants described daily life experiences of chronic pain and opioid therapy. Informed consent and ethical approval were obtained. Six categories were extracted: “Facing injustice or extreme chronic pain and catastrophizing,” “Attempting treatments to improve the condition,” “Ambivalent about receiving medical treatment,” “Barriers to living with chronic pain,” “Finding a compromise while living with chronic pain,” and “Regaining a life.” These findings expand our understanding of Japanese patients received opioid treatment with chronic non-cancer pain and their coping in daily life.

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  • Analysis of cytoskeleton related genes in elderly patients

    Grant number:25670673  2013.4 - 2016.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Challenging Exploratory Research

    Yamakage Michiaki, HAYASE TOMO

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    Grant amount:\3770000 ( Direct Cost: \2900000 、 Indirect Cost:\870000 )

    We investigated whether volatile anesthetics caused postoperative cognitive dysfunction (POCD). In humans, desflurane anesthesia showed a better mini mental examination score than did sevoflurane anesthesia. However, we could not find any genetic polymorphisms associated with cognitive function in humans. To examine the association between general anesthesia and POCD, we investigated whole mRNA expression in mouse hippocampal cells by a transcriptome-wide association study. While expression of the Lhx9 gene was suppressed by exposure to volatile anesthetics in juvenile mice, expression of Lhx9 gene was greatly enhanced by exposure to volatile anesthetics in adult mice. These results suggest that volatile anesthetics affect the differentiation of stem cells in the mouse hippocampus, and the results should be useful for exploring biomarkers of POCD.

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  • Determination of the molecular mechanism of volatile anesthetics using transcriptome analysis in thymo-cortico neurons of mice.

    Grant number:24390366  2012.4 - 2016.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (B)

    Yamakage Michiaki, HAYASE TOMO

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    Grant amount:\17680000 ( Direct Cost: \13600000 、 Indirect Cost:\4080000 )

    We performed a transcriptome-wide association study, a total mRNA analysis, in the mouse brain to try to determine the molecular mechanism of volatile anesthetics. We also examined the behavior of mice to confirm the association between inhalation of volatile anesthetics and undesirable side effects such as nausea, vomiting, and cognitive dysfunction. Exposure to volatile anesthetics caused an increase in the expression level of the Rtn4rl2 gene in all mice and an increase in the expression level of the Lhx9 gene in aged mice. These results indicated that inhalation of volatile anesthetics causes neuroinflammation and induces apoptosis in juvenile mice. However, we did not find undesirable side effects of exposure to the volatile anesthetics in any of the mice. The results suggest that the mechanism by which exposure to volatile anesthetics causes nausea or cognitive dysfunction in mice is different from that in humans.

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  • Investigation about the sex differences and postoperative nausea and vomiting using epigenome-wide association study.

    Grant number:24791606  2012.4 - 2016.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Young Scientists (B)

    Hayase Tomo, YAMAKAGE MICHIAKI

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    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    We investigated whether single nucleotide polymorphisms (SNPs) of the TACR1 gene are associated with postoperative nausea and vomiting (PONV). We found that an SNP within the estrogen response element of the TACR1 gene was strongly associated with decreased frequency of PONV occurrence. Haplotype analysis revealed that patients with a specific haplotype showed lower frequency of PONV occurrence and PONV of less intensity. To determine the association between estrogen and PONV occurrence, we analyzed the methylation rate of the promoter region of the TACR1 gene in humans and investigated whether estrogen promotes the pica behavior in operation model mice. In humans, the intensity of PONV was decreased by methylation of the promoter region of the TACR1 gene. In mice, estrogen and mu-opioid additively promoted pica behavior.

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  • Association of epigenetic modulation in the TACR1 gene with opioid-induced nausea and vomiting

    Grant number:23592301  2011 - 2013

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    SUGINO Shigekazu, YAMAKAGE Michiaki, HAYASE Tomo, TACHIBANA Shun-suke, NAWA Yuko, MORIYA Hiroyuki

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    Grant amount:\5200000 ( Direct Cost: \4000000 、 Indirect Cost:\1200000 )

    We hypothesized that regulation of the TACR1 gene is involved in the individual differences in severity of postoperative nausea and vomiting (PONV). We examined CpG methylation of the promoter region of the TACR1 gene, which modulates NK1 receptor expression in both human blood and mouse the brain. The results of the current study showed that the level of methylation was inversely correlated with the intensity of PONV. This new finding may contribute to preoperative prediction of the severity of PONV in surgical patients.

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  • Association of genetic polymorphisms of the GABRB3 gene with the concentration of propofol at loss of consciousness

    Grant number:23791719  2011 - 2012

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Young Scientists (B)

    NAWA Yuko, SUGINO Shigekazu, HAYASE Tomo, SATO Michiko, TACHIBANA Shun-suke, MORIYA Hiroyuki, YAMAKAGE Michiaki

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    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    We hypothesized that the genetic polymorphisms in the GABRB3 gene are associated with the individual differences in concentration of propofol at loss of consciousness. We examined the genotypes of single nucleotide polymorphisms (SNPs) in the coding sequence of the GABRB3 gene. However, none of the genotyped SNPs were associated with the concentration at loss of consciousness. These results raised the possibility that we need to change the experimental design or to increase the size of the cohort.

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  • Effect of the new inhalation anesthetic Desflurane on airway hyperreactivity

    Grant number:21592019  2009 - 2011

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    YAMAKAGE Michiaki

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    Grant amount:\4290000 ( Direct Cost: \3300000 、 Indirect Cost:\990000 )

    This study reveals the mechanism by which the new inhalation anesthetic, desflurane, affects airway heperreactivity. Desflurane relaxed the smooth muscle in ovalbumin-sensitized guinea pigs in vitro, while, conversely, increasing airway resistance in a dose dependent manner in in vivo experiments. These effects could partly be explained by desflurane activation of the tachykinin pathway. This knowledge will contribute to the anesthetic management of patients with hyperresponsive airways.

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  • Mechanisms and actions of anesthetics on hyperreactive airway in chronic cigarette-smoking model

    Grant number:18390431  2006 - 2008

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (B)

    YAMAKAGE Michiaki

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    Grant amount:\10310000 ( Direct Cost: \9500000 、 Indirect Cost:\810000 )

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  • Mechanism of Dilatory Action of Volatile Anesthetics on Hyperreactive Airway in Chronic Obstructive Pulmonary Disease Model

    Grant number:15591648  2003 - 2005

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    YAMAKAGE Michiaki

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    Grant amount:\3200000 ( Direct Cost: \3200000 )

    Background : Little is known about the inhibitory effects of volatile anesthetics on various hyperreactive airway models and the different effects of volatile anesthetics on airway tone. Methods : The effects of sevoflurane (0〜2.0 MAC), the most widely used volatile anesthetic, on hyperreactive airways in ovalbumin-sensitized and chronic cigarette-smoking guinea pigs were investigated by measuring 1)total lung resistance (R_L), 2)muscle tension and intracellular concentration of free Ca^<2+> ([Ca^<2+>]_i) using tracheal ring preparations, 3)voltage-dependent Ca^<2+> channel (VDCC) activity of tracheal smooth muscle cells, and 4)cyclic AMP levels in tracheal smooth muscles. Results : Ovalbumin and muscarinic airway hyperreactivity was seen in ovalbumin-sensitized animals (acute asthmatic model). Muscarinic hyperreactivity and enlarged alveolar ducts/alveoli were observed in chronic cigarette-smoke animals [a chronic obstructive pulmonary disease (COPD), emphysema, model]. Although sevoflurane inhibited the acetylcholine-induced increase in R_L in the control and asthmatic models, the COPD model showed resistance to sevoflurane. Similarly, in the COPD model, carbachol-induced muscle contraction and increased [Ca^<2+>]_i showed resistance to sevoflurane. Sevoflurane had a smaller inhibitory effect on VDCC activity in the COPD group than in the other two groups. The sevoflurane-induced increase in cyclic AMP that was seen in the control and acute-asthmatic groups was significantly suppressed in the COPD group, resulting in an increase in [Ca^<2+>]_i. Conclusions : The COPD model showed resistance to the effects of sevoflurane. The in vitro mechanism of this resistance seemed to be, at least in part, due to the remodeled airway in which sevoflurane-induced cyclic AMP production was suppressed.

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  • Investigation of Mechanisms of Volatile Anesthetic Action by the Use of Gene Expression Techniques

    Grant number:12671489  2000 - 2002

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    YAMAKAGE Michiaki

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    Grant amount:\3400000 ( Direct Cost: \3400000 )

    In the first year of this investigation, we investigated the effects of the volatile anesthetics isoflurane and sevoflurane on cloned I_<Ks> coexpressed by KvLQT1 and minK. Currents were induced following injection into oocytes of KvLQT1 mRNA with or without minK mRNA, which were transcribed in vitro from cDNAs of normal rats hearts. A Two-electrode voltage-clamp recording technique was used to investigate the effects of isoflurane (0-1.5 MAC) and sevoflurane (0-1.5 MAC) on I_<Ks> (KvLQT1 with mink) and KvLQT1 alone currents. Following a 2-s depolarization to +40 mV, isoflurane and sevoflurane caused potency-dependent reductions in I_<Ks> and KvLQT1 currents. Both of the volatile anesthetics tested accelerated the deactivation of I_<Ks> and KvLQT1 currents. We conclude that the significant inhibitory effect of volatile anesthetics on the cloned I_<Ks > may partly contribute to the clinical observations of the prolongation of the ventricular repolarization (Q-T interval) by the anesthetics. In the following year, we cloned another truncated splice variant of LCNQ1 from rat heart. Judging from the deleted sequence of the TCNQT1, the genomic structure of rat in this portion might be different from those of human and mouse. In the last year, we investigated the single-channel properties of the Ca^<2+> channels reconstituted with β_<2a> or β_<2c> subunit, and compared them with the properties of naive channel. In contrast to β_<2a> subunit, long-lasting closings were dominant in the Ca^<2+> channel with β^<2c> subunit and the native channel. The single-channel properties of Ca^<2+> channel with β_<2c> subunit were indistinguishable from those of native channel. Those findings suggest that β_<2c> subunit is one of the functional β subunits in the rat heart.

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  • 気道平滑筋に及ぼす環境変化と麻酔薬との相互作用ならびに作用機序の解明

    Grant number:10770762  1998 - 1999

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    山蔭 道明

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    Grant amount:\2000000 ( Direct Cost: \2000000 )

    提出した研究計画に従い,本年度は気道平滑筋収縮に対する環境変化,とくに低温暴露の影響について観察した.研究費は低温環境を作製するためにバイオウォーマー(ナリシゲ)を購入したほか,単離細胞等を作製する際に必要な消耗品等に充当した.本年度は前年度の平滑筋張力と[Ca^<2+>]iの同時測定の結果を踏まえてパッチクランプ法による電位依存性カルシウムチャンネル(VDC)活性の測定を行った.材料として雑種成犬およびブタの気管平滑筋組織を用いた.平滑筋組織をコラゲナーゼなどの酵素でインキュベートし,気管平滑筋の単離細胞を得た.得られた気管平滑筋細胞を用いて,倒立顕微鏡下で細胞をパッチし,パッチクランプアンプで膜電位固定した.ホールセルモードにてVDCを介して流入するカルシウムの内向き電流を得た.温度変化は37℃,31℃とし,一定の変化を得た後吸入麻酔薬イソフルランとセボフルランを暴露し,カルシウム電流の変化を観察した.低温暴露はカルシウムの内向き電流を有意に抑制した.この効果は吸入麻酔薬暴露時でも同様であった.不活性化曲線も有意に左方にシフトした.つまり,前年度に得られた低温暴露による[Ca^<2+>]iの低下の結果と一致する結果が得られた.低温暴露による[Ca^<2+>]iの低下の原因として,細胞膜電位依存性カルシウムチャネルの抑制が関与していることが考えられた.その効果は活性化ならびに不活性化状態でも観察された.受容体刺激薬による収縮の際に低温暴露が収縮を増強させるのは,カルシウムイオンに関与しない因子が考えられた.この結果は,喘息患者が低温暴露時に喘息発作を引き起こしやすいことと一致する.

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  • 血液凝固系

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    Grant type:Competitive

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  • 麻酔薬の作用機序の解明

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    Grant type:Competitive

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  • 周術期の体温管理

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    Grant type:Competitive

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