Education 【 display / non-display 】

Education 【 display / non-display 】

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  1984

  Sapporo Medical University  

Professional Memberships 【 display / non-display 】

Professional Memberships 【 display / non-display 】

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  Japan Society of Critical Care Medicine

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  日本集中治療医学会

Research Areas 【 display / non-display 】

Research Areas 【 display / non-display 】

• Life sciences   Emergency medicine  

Affiliation 【 display / non-display 】

Affiliation 【 display / non-display 】

• Sapporo Medical University   Department of Intensive Care Medicine   Professor  

Papers 【 display / non-display 】

Papers 【 display / non-display 】

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

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

  JOURNAL OF ANESTHESIA ( SPRINGER JAPAN KK )  28 ( 4 ) 610 - 612  2014.08  [Refereed]

  　View Summary

  We encountered a 2-year-old child with life-threatening hypercapnia, with a PaCO2 of 238 mm Hg and severe respiratory and metabolic acidosis, due to status asthmaticus that was refractory to steroid and bronchodilator therapy. Suspecting ventilatory failure and excessive ventilation-induced obstructive shock, we started respiratory physiotherapy in synchrony with her respiration, to facilitate exhalation from her over-inflated lungs. Isoflurane inhalation was commenced in preparation for extracorporeal circulation, to reduce the hypercapnia. The combination of respiratory physiotherapy and isoflurane inhalation resulted in a rapid decrease in ventilatory resistance and PaCO2 levels within a few minutes, with recovery of consciousness within 60 min. Isoflurane inhalation was gradually discontinued and steroid and aminophylline therapy were commenced. The patient recovered completely without any recurrence of her bronchospasm and without any residual neurological deficits. In our patient with a severe asthmatic attack, decreased exhalation secondary to asthma and overventilation during artificial ventilation resulted in overinflation of the lungs, which in turn led to cerebral edema and obstructive cardiac failure. The favorable outcome in this case was due to the short duration of hypercapnia. Hence, we conclude that the duration of hypercapnia is an important determinant of the morbidity and mortality of status asthmaticus-induced severe hypercapnia.

  DOI

• Asialoglycoprotein receptor scintigraphy with Tc-99m-galactosyl human serum albumin (Tc-99m-GSA) as an early predictor of survival in acute liver failure

  H. Tatsumi, Y. Masuda, H. Imaizumi, S. Yoshida, K. Goto, N. Yama, T. Mizuguchi, K. Hirata

  ANAESTHESIA AND INTENSIVE CARE ( AUSTRALIAN SOC ANAESTHETISTS )  41 ( 4 ) 523 - 528  2013.07  [Refereed]

  　View Summary

  This study evaluated the usefulness of asialoglycoprotein receptor scintigraphy with Tc-99m-galactosyl human serum albumin (Tc-99m-GSA scintigraphy) as an early predictor for prognosis of acute liver failure. Forty-eight patients with acute liver failure and without a past history of chronic liver disease were enrolled. Patients were divided into survival and non-survival groups by 28-day mortality. Tc-99m-GSA scintigraphy to detect uptake ratio of the heart at 15 minutes to that at three minutes (HH15) and uptake ratio of the liver at 15 minutes to the liver plus the heart at 15 minutes (LHL15), and measurements of serum total bilirubin, hepatocyte growth factor and prothrombin time were performed immediately after the diagnosis of acute liver failure. Areas under the receiver operating characteristic curves were used to compare the prognostic ability of total bilirubin, hepatocyte growth factor, prothrombin time, HH15 ratio, LHL15 ratio and the model for end-stage liver disease score. Clinical characteristics of patients in the survival group (n=20) and in the non-survival group (n=28) Were not significantly different. HH15 and LHL15 uptake ratios in the survival group were 0.670 and 0.875 and they were significantly lower and higher than those in the non-survival group, respectively. All patients with LHL15 <0.760 died, and the area under the receiver operating characteristic curve for LHL15 were significantly larger than the areas under the receiver operating characteristic curves of serum variables and model for end-stage liver disease score. In summary, in patients with acute liver failure without chronic liver disease, HH15 and LHL15 of Tc-99m-GSA scintigraphy are more useful variables in predicting prognosis than serum variables and model for end-stage liver disease score.

• Neutralization of receptor for advanced glycation end-products and high mobility group box-1 attenuates septic diaphragm dysfunction in rats with peritonitis

  Yasuyuki Susa, Yoshiki Masuda, Hitoshi Imaizumi, Akiyoshi Namiki

  CRITICAL CARE MEDICINE ( LIPPINCOTT WILLIAMS & WILKINS )  37 ( 9 ) 2619 - 2624  2009.09  [Refereed]

  　View Summary

  Objectives: To determine the relationship between intra-abdominal sepsis-induced high mobility group-box 1 and diaphragm contractile performance and to determine the inhibitory effects of antibodies for high mobility group-box I and receptor for advanced glycation end-products on septic peritonitis-induced diaphragmatic dysfunction, lipid peroxidation, and intracellular signal transduction in the rat diaphragm. In animal models of sepsis, production of reactive oxygen species has been shown to elicit diaphragmatic dysfunction. Extracellularly released high mobility group-box 1 can bind to cell surface receptors, such as receptor for advanced glycation end-products, eliciting inflammatory responses that lead to the development of sepsis. Design: Prospective laboratory study. Setting: University laboratory. Subjects: Wistar rats (n = 186). Interventions: Intra-abdominal sepsis was induced, using cecal ligation and perforation. In experiment 1, serum and diaphragm homogenates were obtained from sham-operated rats and from cecal ligation and perforation rats at 4-hr intervals postoperatively. In experiment 2, anti-high mobility group-box 1 and anti-receptor for advanced glycation end-products antibodies were administered 4 firs and 8 hrs after cecal ligation and perforation to determine their effects on cecal ligation and perforation-induced diaphragm dysfunction, reactive oxygen species-related variables, and intracellular signal transduction. Measurements and Main Results: In experiment 1, cecal ligation and perforation induced serum and diaphragmatic high mobility group-box 1 within 8 firs postoperatively with a decline in diaphragmatic force generation at 12 firs after cecal ligation and perforation. In experiment 2, anti-receptor for advanced glycation end-products and anti-high mobility group-box 1 antibodies significantly attenuated cecal ligation and perforation-induced diaphragmatic dysfunction in a dose-related manner. Diaphragmatic malondialdehyde concentration and phosphorylation level of extracellular signal-regulated kinase 1/2 in the groups treated with these antibodies were significantly lower than those in the nontreated group. Anti-receptor for advanced glycation end-products antibody down-regulated high mobility group-box 1 expression in the diaphragm during sepsis. Conclusions: Cecal ligation and perforation induces high mobility group-box 1 in the diaphragm and increases serum high mobility group-box 1 level as a late-phase mediator, decreasing contractile performance by high mobility group-box 1 receptor for advanced glycation end-products interaction-mediated reactive oxygen species production. These findings suggested an important role of receptor for advanced glycation end-products-high mobility group-box 1 interaction in diaphragmatic dysfunction induced by lipid peroxidation in rats with intra-abdominal sepsis. (Crit Care Med 2009; 37:2619-2624)

  DOI

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

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

  ANAESTHESIA AND INTENSIVE CARE ( AUSTRALIAN SOC ANAESTHETISTS )  32 ( 4 ) 588 - 591  2004.08  [Refereed]

  　View Summary

  Toxic shock syndrome is a rare but potentially fatal toxin-mediated febrile illness. We report a case of toxic shock syndrome complicated by life-threatening organ dysfunction with high toxin-1 and staphylococcus enterotoxin type A levels that were successfully reduced by early introduction of plasma exchanges. The report shows the time course of the concentrations of anandamide and 2-arachidonyl glyceride and confirms that early introduction of plasma exchange can result in a rapid reduction of circulating toxins and mediators in the treatment of life-threatening multiple organ dysfunction.

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

  山蔭 道明, 紅露 伸司, 升田 好樹, 並木 昭義

  JJSCA ( THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA )  17 ( 9 ) 502 - 504  1997

  DOI CiNii

Misc 【 display / non-display 】

Misc 【 display / non-display 】

• 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 ( LIPPINCOTT WILLIAMS & WILKINS )  43 ( 12 )  2015.12

  Research paper, summary (international conference)  

• A case of cardiopulmonary arrest caused by laxatives-induced hypermagnesemia in a patient with anorexia nervosa and chronic renal failure

  TATSUMI Hiroomi, MASUDA Yoshiki, IMAIZUMI Hitoshi, KURODA Hiromitsu, YOSHIDA Shin-ichiro, KYAN Ryoko, GOTO Kyoko, ASAI Yasufumi

  Journal of anesthesia   25 ( 6 ) 935 - 938  2011.12

  CiNii

• Successful extracorporeal membranous oxygenation for a patient with life-threatening transfusion-related acute lung injury

  KURODA HIROMITSU, MASUDA YOSHIKI, IMAIZUMI HITOSHI, KOZUKA YUJI, ASAI YASUFUMI, NAMIKI AKIYOSHI

  Journal of anesthesia   23 ( 3 ) 424 - 426  2009.08

  CiNii

• マニュアルジェットベンチレータと経皮的気管切開キットによる緊急気道確保 Fresh Cadaver Study

  本間 広則, 杉野 繁一, 関 忍, 中山 雅康, 升田 好樹, 今泉 均, 青木 光広, 鈴木 大輔, 辰巳 治之, 並木 昭義

  日本集中治療医学会雑誌 ( (一社)日本集中治療医学会 )  15 ( Suppl. ) 191 - 191  2008.01

• Comparison of surgical versus endovascular stent-graft repair of thoracic and thoracoabdominal aortic aneurysms in terms of postoperative organ failure

  Yuko Nawa, Yoshiki Masuda, Hitoshi Imaizumi, Yasuyuki Susa, Yoshihiko Kurimoto, Takashi Sawai, Yasufumi Asai, Akiyoshi Namiki

  Japanese Journal of Anesthesiology   53 ( 11 ) 1253 - 1258  2004.11

  　View Summary

  Background: We conducted this study to clarify whether the incidence of organ failure after endovascular stent-graft repair of thoracic aneurysm (TAA) and thoracoabdominal aneurysm (TAAA) is much higher than that after surgical repair. Methods: The diseases for surgical repair (surgical group) were TAA in 29 patients and TAAA in 19 patients. Fourteen patients underwent stent-graft repair for TAA and TAAA (stent group). Incidences of preoperative complications in the two groups were compared. Postoperative organ failures, changes in SOFA score and numbers of SIRS criteria were assessed over a period of 7 postoperative days. Results: Although the incidence of preoperative complications in the stent group was significantly higher than that in the surgical group, postoperative organ failure in the surgical group was more frequent than that in the stent group. SOFA score in the stent group during the first 3 postoperative days was significantly smaller than that in the surgical group. However, the number of SIRS criteria in the stent group was significantly higher than that in the surgical group on the first postoperative day. Conclusions: Endovascular stent-graft repair for arotic aneurysm may be less invasive, leading to a reduction in the incidence of postoperative organ failure in high-risk patients.

  PubMed

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Research Projects 【 display / non-display 】

Research Projects 【 display / non-display 】

• トロンボモジュリンによるcell-free DNA制御と臓器障害軽減機序の解明

  基盤研究(C)

  Project Year :

  2022.04

  -

  2025.03

   

  赤塚 正幸, 升田 好樹

• DAMPsを制御するペプチドの開発とその応用展開

  基盤研究(B)

  Project Year :

  2021.04

  -

  2024.03

   

  川原 幸一, 升田 好樹, 伊藤 隆史, 三浦 直樹, 中原 真由美, 菊池 清志, 寺崎 寛人

  　View Summary

  敗血症は世界のどこかで3秒に1人が亡くなる疾患である。ゆえに敗血症治療法の開発は喫緊の課題である。敗血症の定義の改定により、DAMPsが注目され、DAMPsの封じ込めは必須である。DAMPsの封じ込めには、受容体のアンタゴニスト、受容体の細胞内ドメインの活性化部位の阻害などが行われている。しかしながら、完全なDAMPsの封じ込めに至っていない。よって、本研究（2021年度）では、新たなDAMPsの封じ込めを目的とする。 本年度（2021年度）はDAMPsの封じ込めにおいて、封じ込め可能な分子の探索を行った。その結果、いくつかの候補分子が認められた。同時に、DAMPs分子のサイトカイン産生（インターロイキン６、インターロイキン８、TNF-alpha）の最適化条件を、THP-1細胞をホルボール12‐ミリスタート13‐アセタート(PMA)で分化させたマクロファージを用いて行った。

• The Web System and Prognostic Model for Mental Support of Critically Ill Patients and Families

  Grant-in-Aid for Scientific Research (C)

  Project Year :

  2021.04

  -

  2024.03

   

  石貫 智裕, 原田 敬介, 升田 好樹, 水口 徹, 大柳 俊夫, 成松 英智, 巽 博臣

  　View Summary

  ICUダイアリーが重症患者の精神状態やQOLに与える影響を検証するためにメタ解析を行った。ICUダイアリーを使用したRCT研究は5件が該当した(#CRD42020198973)。対照群は一般的なケアが行われ、アウトカムは精神状態についてHADS (不安・抑うつ)とIES-R (PTSD)、QOLについてSF-36 (PCSとMCS) が使用された文献を採用した。メタ解析の結果、ICUダイアリーにより不安は有意に改善することが明らかとなった（P=0.01）。一方で、抑うつ (P=0.05)とPTSD (P=0.10)は改善しなかった。また、SF-36はPCS (P=.28)も MCS (P=0.35) も改善しなかった。よって、ICUダイアリーのみの介入では重症患者の精神状態やQOLに対する効果が十分でないことが明らかとなった。 ウェアラブルデバイスから得られる睡眠データの精度の検証、および従来の睡眠評価方法 (RCSQ) との関連の検証を目的にパイロット研究を実施した。2名の対象者が30日間FitbitとGo2sleepを装着し、RCSQとともに毎日データを収集した。Fitbitの睡眠スコア (平均値±標準偏差) は77.93±7.42、睡眠時間 (分) は376.23±82.85だった。また、Go2sleepの睡眠スコアは73.83±19.73、睡眠時間 (分) は358.79±129.60だった。さらに、RCSQは47.01±10.52であった。Fitbitの睡眠スコアとRCSQの相関係数は0.88 (P<0.001)、決定係数は0.78であった。この結果から、ウェアラブルデバイスはGo2sleepよりもFitbitのデータの方が精度が高いことが明らかとなった。Fitbitのデータは従来の評価方法との相関も強く、睡眠研究に十分耐えられることが明らかとなった。

• 敗血症症例におけるDAMPs制御がImmunoparesisへ影響するか

  基盤研究(C)

  Project Year :

  2021.04

  -

  2024.03

   

  黒田 浩光, 升田 好樹

  　View Summary

  本研究は集中治療室の敗血症患者のDAMPsとImmunoparesisとの関係を明らかにする目的である。 2021年度の本研究の成果は，まず病院倫理審査委員会の研究承認を経て，実際に対象患者から同意取得後に採血とフローサイトメトリー検査，血漿保存を開始した。 まだ，症例数が少ないため，一括検査を行う検体数に至っていないため，DAMPsやサイトカインの血中濃度については測定できていない。

• Symptom and Quality of Life after Intensive Care in Japan

  Grant-in-Aid for Scientific Research (C)

  Project Year :

  2019.04

  -

  2022.03

   

  Takeshi Unoki

  　View Summary

  An ambidirectional cohort study was conducted at 12 ICUs in Japan. Patients who stayed in the ICU for > 3 nights and were living at home for 1 year afterward were included. One year after ICU discharge, we retrospectively screened patients and performed a mail survey on a monthly basis, including the Impact of IER-S, HADS, and EQ-5D-L questionnaires. 854 patients were surveyed by mail. Of these, 778 patients responded (response rate = 91.1%). The data from 754 patients were analyzed. The prevalence of suspected PTSD, anxiety, and depression were 6.0%, 16.6%, and 28.1%, respectively. EQ-5D-L scores were lower in our participants than in the sex- and age-matched Japanese population. Unplanned admission was an independent risk factor for more severe PTSD, anxiety, and depressive symptoms. Approximately one-third of patients in the ICU population experienced mental health issues one year after ICU discharge. Unplanned admission was an independent predictor for more severe PTSD symptoms.

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