Misc - YAMAKAGE Michiaki

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

YAMAKAGE Michiaki

Biomedical thermology : the journal of the Japanese Society of Thermorogy = 医学・生物学サーモロジー   26 ( 2 ) 29 - 34  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 ( 日本臨床麻酔学会 )  26 ( 6 ) S413 - S413  2006.10

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

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

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

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

日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia   26 ( 5 ) 594 - 601  2006.09

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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 ( (株)メディカル・サイエンス・インターナショナル )  13 ( 6 ) 592 - 598  2006.06

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過去3年間のクリニカル・クラークシップ(CC)教育プログラムに対する学生の評価ならびにそのフィードバックに関して解析し検討した.必修CCを受けた2003〜2005年度の第5〜6学年学生(101,104,95例)を対象とした.学生からの評価を教育プログラムにフィードバックして改善した.毎年評価が上がり,2005年度は全科を通して最も高い評価を得た.主な変更点は,教育熱心な教員への担当変更,カルテ記入・患者診察の機会提供,緩和医療チームへの参加であった.項目別では,「医療手技の機会提供」が3年間を通して最も高い評価が得られた

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

Journal of anesthesia   20 ( 2 ) 145 - 148  2006.05

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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 ( メディカ出版 )  21 ( 5 ) 521 - 525  2006.05

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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 ( メディカ出版 )  21 ( 3 ) 322 - 324  2006.03

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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  2006.02

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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 ( 克誠堂出版 )  54 ( 12 ) 1385 - 1391  2005.12

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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 ( メディカ出版 )  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 ( メディカ出版 )  20 ( 9 ) 876 - 879  2005.09

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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 ( 真興交易(株)医書出版部 )  29 ( 8 ) 1353 - 1356  2005.08

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

Journal of anesthesia   19 ( 2 ) 183 - 184  2005.05

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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 ( BLACKWELL MUNKSGAARD )  49 ( 5 ) 660 - 664  2005.05

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Background: Intermittent pneumatic foot compression (IPC) is a useful technique for prophylaxis of peri-operative venous thromboembolism. The aim of this study was to determine the effect of IPC on blood coagulation/fibrinolysis and platelet function using a blood viscometer (Sonoclot(TM)) and a platelet aggregation monitor (WBA analyzer(TM)), respectively. Using the same blood samples, serum levels of tissue-type plasminogen activator (t-PA), thrombomodulin (TM) and activated protein C (APC) were also measured. Methods: The soles and legs of each subject (n = 8) were compressed for 3 s (130 mmHg) at a 0.3-Hz interval using an IPC device. Parameters were measured 2 min before and at the end of 60-min compression. Results: Parameters of the Sonoclot time-to-peak were shortened and clot retraction rate was increased significantly by IPC, whereas the other parameters did not change. These results indicate that IPC can activate blood fibrinolysis but not coagulability. A parameter of the WBA analyzer PATI (platelet aggregatory threshold index) did not change, indicating that IPC cannot activate platelet function per se. The concentration of t-PA decreased slightly but significantly. A decrease in the concentration of t-PA can lead to activation of fibrinolysis. Other humoral parameters did not change, indicating that IPC has no effect on endothelial function. Although neither blood coagulability nor platelet function were affected by IPC, fibrinolytic activity increased slightly, probably by activation of t-PA function. Conclusion: IPC is useful for prophylaxis for thromboembolism by activation of blood fibrinolysis as well as inhibition of blood stasis.

DOI

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 ( 真興交易(株)医書出版部 )  29 ( 5 ) 846 - 848  2005.05

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クロニジンを前投与して全身麻酔管理を行った63名中5名が,筋弛緩拮抗薬ネオスチグミン投与直後に腹痛を発症した.2名は自然寛解したが,残りの3名はブチルスコポラミンの投与を必要とした.前投薬として使用したクロニジン,筋弛緩拮抗薬のネオスチグミンの相互作用による自律神経のアンバランスが機序として推測された.クロニジンは少量でかつ単回投与で消化管運動に影響を与えることが指摘されているため,筋弛緩拮抗薬などの自律神経作用薬との相互作用により腹痛などの合併症を引き起こすことがある(著者抄録)

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  2005.05

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Background: Portfolio as one of the educational techniques was introduced to elective clinical clerkship (CC) of Anesthesiology in Sapporo Medical University School of Medicine in the 2003 fiscal year. Methods: Fourteen medical students who elected Anesthesiology CC for 3 weeks had a duty to study and feed back their CC everyday by writing portfolio, and the attending checked and fed back their portfolio every week. At the end of the CC, questionnaire surveys by 5 step Likert measure and group discussion were conducted to determine the evaluation by students of the portfolio in Anesthesiology CC. Results: The average score of the questionnaire surveys was high (4.78). However, the scores of usefulness of the portfolio for feedback to student's attitude and to good relationship among medical staff were relatively low (4.6 and 4.4, respectively). Conclusions: The use of a portfolio as a educational technique in elective CC seems to be useful, and further education to chief/senior medical staff for feedback to student's attitude and other kinds of educational techniques for feedback to good relationship among medical staff are needed.

PubMed

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  2005.05

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Background: Clinical Clerkships in the Department of Anesthesiology were evaluated by undergraduate medical students and compared with other clinical departments and those of previous fiscal year 2003. Methods: Questionnaire surveys by 5 step Likert measure were conducted to ask the students for the evaluation of each department or division, and formative evaluation was performed after the all clerkships. The questionnaire consisted of 12 questions on 1) orientation, 2) learning chances and provision of teaching materials, 3) feedback, learning promotion and teaching attitude, 4) coordination of human relationship between medical staff and students, and 5) overall evaluation of teacher's physician. Results: The average score of our department was 4.40 (mean, 5th grade of all 26 departments/divisions), and the score of the question on provision of medical practice (4.71) was the best among the all departments/divisions. The evaluation grading was rather low for the question on chance for physical examinations (3.80). Conclusions: Reevaluation of the educational program in our department based on the results of the survey is essential for improvement of the program, and further provision of chances, especially for physical examinations, is also needed for undergraduate students in the program by including palliative medical care program.

PubMed

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 ( 克誠堂出版 )  54 ( 5 ) 551 - 556  2005.05

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