論文 - 佐々木　淳一

Effect of retroperitoneal pelvic packing on pelvic cavity pressure

Sato Yukio, Sekine Kazuhiko, Shibusawa Takayuki, Tajima Kosuke, Sasaki Junichi, Imanishi Nobuaki, Aiso Sadakazu, Hori Shingo

Orthopedics 40 （ 6 ） e947 - e951 2017年11月

ISSN  0147-7447

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<p>Limited clinical evidence demonstrates the effectiveness of direct retroperitoneal pelvic packing for hemorrhage control in pelvic fractures due to the difficulty in measuring pressure on the pelvic walls within the pelvic cavity after retroperitoneal pelvic packing. Using a cadaver model, the authors aimed to assess whether retroperitoneal pelvic packing generates pressure that exceeds the venous return and arterial pressure in the pelvis. The pressure on the pelvic wall was measured in 5 fresh Japanese cadavers. Sensors were placed at 4 points on the pelvic wall, and the pressure at each point was measured after the insertion of each of 3 sponges, per the procedure originally described for direct retroperitoneal pelvic packing. In each specimen, the average pressure across all 4 points on the pelvic wall increased with the addition of each sponge, reaching 12.3±4.5 mm Hg when all 3 sponges were inserted. Furthermore, the pressure at the pelvic floor and posterior pelvic brim increased significantly, whereas the pressure at the anterior and middle pelvic brim increased nonsignificantly. The results of this study suggest that retroperitoneal pelvic packing provides pressure on the pelvic wall that exceeds the venous pressure and is thus effective for the control of venous hemorrhage in pelvic fractures. Currently, the recommended procedure combines external fixation for venous bleeding, transcatheter arterial embolization, and pelvic packing; however, the authors' results suggest that pelvic packing alone may be effective for controlling venous hemorrhage in pelvic fracture.</p>

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Early Use of Hydrogen Gas Inhalation Improves Survival in Rats With Lethal Hemorrhagic Shock

佐々木 淳一

CIRCULATION 136 2017年11月

研究論文（学術雑誌）,  ISSN  0009-7322

Association Between Renal Dysfunction and Outcomes in Out-of-Hospital Cardiac Arrest Patients: A Prospective, Multicenter Observational Study (SOS-KANTO 2012 Study)

佐々木 淳一

CIRCULATION 136 2017年11月

研究論文（学術雑誌）,  ISSN  0009-7322

Hydrogen gas inhalation inhibits progression to the "irreversible" stage of shock after severe hemorrhage in rats

佐々木 淳一

JOURNAL OF TRAUMA AND ACUTE CARE SURGERY 83 （ 3 ） 469 - 475 2017年09月

研究論文（学術雑誌）,  ISSN  2163-0755

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Hyperfibrinolysis in severe isolated traumatic brain injury may occur without tissue hypoperfusion: a retrospective observational multicentre study

佐々木 淳一

CRITICAL CARE 21   469 - 475 2017年08月

研究論文（学術雑誌）,  ISSN  1466-609X

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The Effects of Hydrogen Gas Inhalation on Adverse Left Ventricular Remodeling After Percutaneous Coronary Intervention for ST-Elevated Myocardial Infarction - First Pilot Study in Humans -

佐々木 淳一

CIRCULATION JOURNAL 81 （ 7 ） 940 - + 2017年07月

研究論文（学術雑誌）,  ISSN  1346-9843

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A Dipeptidyl Peptidase-4 Inhibitor, Teneligliptin, Decreases Plasma Triglyceride-Rich Lipoprotein Remnants in Diabetic Patients with Chronic Kidney Disease Undergoing Hemodialysis

Homma Koichiro, Yoshizawa Joe, Shiina Yutaka, Ozawa Hideki, Igarashi Muneki, Matsuoka Tadashi, Sasaki Junichi, Yoshizawa Mamoru, Homma Yasuhiko

Drugs in R and D    1 - 6 2017年06月

ISSN  1174-5886

　概要を見る

<p>Objective: A high plasma level of remnant-like particle cholesterol (RLP-C), which is equivalent to triglyceride-rich lipoprotein remnant, is an important coronary risk marker. RLP-C level is high, independent of other plasma lipids, in patients with chronic kidney disease (CKD) undergoing hemodialysis. The effect of teneligliptin, a dipeptidyl peptidase (DPP)-4 inhibitor, on plasma levels of RLP-C in patients with diabetes mellitus and CKD under hemodialysis was studied. Methods: Teneligliptin 20 mg/day was administered to 15 patients with diabetes and CKD undergoing hemodialysis for 12 weeks. Ten patients with diabetes and CKD undergoing hemodialysis were allocated to the control group. Blood was sampled following a 12-h fast. Fasting plasma glucose (FPG), C-peptide, triglyceride, low-density lipoprotein (LDL)-cholesterol (C), high-density lipoprotein (HDL)-C, RLP-C, apolipoprotein (apo) B, oxidized LDL, lipoprotein lipase, and glycated hemoglobin (HbA1c) were measured. Results: HbA1c decreased in the teneligliptin group but significantly increased in the control group. FPG and RLP-C significantly decreased in the teneligliptin group. Plasma lipoprotein-related parameters except RLP-C were not affected by teneligliptin treatment. Conclusion: Teneligliptin treatment significantly reduced plasma levels of RLP-C, FPG, and HbA1c in patients with diabetes with CKD who are undergoing hemodialysis.</p>

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Effectiveness of early administration of tranexamic acid in patients with severe trauma

Shiraishi A., Kushimoto S., Otomo Y., Matsui H., Hagiwara A., Murata K., Hayakawa M., Maekawa K., Saitoh D., Ogura H., Sasaki J., Shibusawa T., Uejima T., Yaguchi A., Takeda M., Ishikura H., Nakamura Y., Kudo D., Kaneko N., Matsuoka T., Hagiwara Y., Morimura N., Furugori S., Kato H., Kanemura T., Mayama G., Kim S., Takasu O., Nishiyama K.

British Journal of Surgery 104 （ 6 ） 710 - 717 2017年05月

ISSN  0007-1323

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<p>Background: A reduction in mortality with the early use of tranexamic acid has been demonstrated in severely injured patients who are bleeding. However, the modest treatment effect with no reduction in blood transfusion has raised concerns. The aim of the present study was to estimate the effectiveness of regular use of tranexamic acid in severely injured patients. Methods: This multicentre observational study used retrospectively collected data from consecutive injured patients (Injury Severity Score at least 16) treated in 15 Japanese academic institutions in 2012. A propensity score-matched analysis compared patients who did or did not receive tranexamic acid administration within 3 h of injury. Study outcomes included 28-day all-cause and cause-specific mortality, and need for blood transfusion. Results: Of 796 eligible subjects, 281 were treated with tranexamic acid. Propensity score matching selected a total of 500 matched subjects (250 in each group). Tranexamic acid administration was associated with lower 28-day mortality (10·0 versus 18·4 per cent; difference −8·4 (95 per cent c.i. –14·5 to −2·3) per cent) and lower 28-day mortality from primary brain injury (6·0 versus 13·2 per cent; difference −7·2 (−12·3 to −2·1) per cent). However, there was no significant difference between groups in the need for blood transfusion (33·2 versus 34·8 per cent; difference −1·6 (−9·9 to 6·7) per cent). Conclusion: Early tranexamic acid use was associated with reduced mortality in severely injured patients, in particular those with a primary brain injury.</p>

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Clinical study on levofloxacin injection for surgical infection

Kusachi Shinya, Oe Keiji, Okuda Yasuyuki, Sasaki Junichi, Maetani Iruru, Watanabe Manabu, Takuma Kiyotsugu, Orito Etsuro, Shimizu Junzo

Japanese Journal of Chemotherapy 65 （ 3 ） 445 - 455 2017年05月

ISSN  1340-7007

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<p>We evaluated the efficacy and safety of levofloxacin (LVFX) injection 500 mg once-daily by intravenous infusion for 3 days to 14 days in patients with the secondary infections of injury, burns, or surgical wounds, acute cholecystitis, or acute cholangitis. The utility of sequential therapies, from LVFX injection to LVFX oral agent, for the treatment of surgical infection was evaluated. Additionally, the drug penetration into gallbladder bile and duct bile after administrating 500 mg of LVFX by injection was determined in patients with biliary tract infections. Clinical efficacy: The clinical efficacy rate at test of cure (primary endpoint) was 90.0% (9/10) in patients with the secondary infections of injury, burns or surgical wounds. All five patients with acute cholecystitis and all three patients with acute cholangitis were evaluated as cured. Microbiological efficacy: The microbiological efficacy rate at test of cure was 90.0% (9/10) in patients with the secondary infections of injury, burns or surgical wounds. Three (out of five) patients with acute cholecystitis and three patients with acute cholangitis were evaluated as demonstrating microbial eradication. Pharmacokinetics: The concentration of LVFX in gallbladder bile and duct bile after administrating LVFX injections was measured in two patients with acute cholecystitis (gallbladder bile) and four patients with acute cholangitis (duct bile). The LVFX concentration in gallbladder bile 3 h after starting infusion in the two patients was 13.9 μg/mL and 24.5 μg/mL, respectively. The gallbladder bile to plasma concentration ratios were 1.78 and 2.16, respectively. The mean value of the LVFX concentration in duct bile 3 h after starting infusion in the four patients was 12.0 jig/mL (range: 9.0 μg/mL-15.6 μg/mL). The mean value of duct bile to plasma concentration ratio was 1.82 (range: 1.37-2.31). Safety: The incidence rates of adverse events (AEs) and adverse drug reactions (ADRs) were 63.6% (14/ 22) and 13.6% (3/22), respectively. The severities of all ADRs were mild, and all patients who had any ADRs recovered. From these results, LVFX injection 500 mg once-daily was shown to be useful for the treatment of the secondary infections of injury, burns, or surgical wounds, acute cholecystitis, and acute cholangitis, and it was demonstrated that there were no significant problems with its safety.</p>

Fibrinogen level on admission is a predictor for massive transfusion in patients with severe blunt trauma: Analyses of a retrospective multicentre observational study

佐々木 淳一

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 48 （ 3 ） 674 - 679 2017年03月

研究論文（学術雑誌）,  ISSN  0020-1383

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Effect of Retroperitoneal Pelvic Packing on Pelvic Cavity Pressure: A Cadaveric Study

佐々木 淳一

ORTHOPEDICS 40 （ 6 ） E947 - E951 2017年01月

研究論文（学術雑誌）,  ISSN  0147-7447

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Initial management of trauma patients for urologists

Shibusawa Takayuki, Sasaki Junichi

Japanese Journal of Clinical Urology 71 （ 3 ） 208 - 212 2017年

ISSN  0385-2393

The effects of hydrogen gas inhalation on adverse left ventricular remodeling after percutaneous coronary intervention for ST-elevated myocardial infarction

Katsumata Yoshinori, Sano Fumiya, Abe Takayuki, Tamura Tomoyoshi, Fujisawa Taishi, Shiraishi Yasuyuki, Kohsaka Shun, Ueda Ikuko, Homma Koichiro, Suzuki Masaru, Okuda Shigeo, Maekawa Yuichiro, Kobayashi Eiji, Hori Shingo, Sasaki Junichi, Fukuda Keiichi, Sano Motoaki

Circulation Journal 81 （ 7 ） 940 - 947 2017年

ISSN  1346-9843

　概要を見る

<p>Background: Hydrogen gas inhalation (HI) reduced infarct size and mitigated adverse left ventricular (LV) remodeling in a rat model of acute myocardial infarction (AMI). We designed a prospective, open-label, rater-blinded clinical pilot study in patients experiencing ST-elevated MI (STEMI). Methods and Results: The 20 patients with an initial diagnosis of STEMI were assigned to either an HI group (1.3% H2 with 26% oxygen) or a control group (26% oxygen). There were no HI-related severe adverse events. In the full analysis set, the cardiac salvage index as evaluated using cardiac magnetic resonance imaging at 7 days after primary percutaneous coronary intervention (PCI), showed no significant between-group difference (HI: 50.0±24.3%; control: 60.1±20.1%; P=0.43). However, the improvement from day 7 in the HI group was numerically greater than that in the control group in some of the surrogate outcomes at 6-month follow-up, including the LV stroke volume index (HI: 9.2±7.1 mL/m²; control: -1.4±7.2 mL/m²; P=0.03) and the LV ejection fraction (HI: 11.0%±9.3%; control: 1.7%±8.3%; P=0.11). Conclusions: The first clinical study has shown that HI during PCI is feasible and safe and may also promote LV reverse remodeling at 6 months after STEMI. The study was not powered to test efficacy and a further large-scale trial is warranted. (Clinical trials registration: UMIN00006825).</p>

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Generation of kidney tubular organoids from human pluripotent stem cells

佐々木 淳一

SCIENTIFIC REPORTS 6   674 - 679 2016年12月

研究論文（学術雑誌）,  ISSN  2045-2322

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Hydrogen Gas Inhalation Improves Survival in Rats With Lethal Hemorrhagic Shock Resuscitated With Saline

佐々木 淳一

CIRCULATION 134 2016年11月

研究論文（学術雑誌）,  ISSN  0009-7322

DAMAGE ASSOCIATED MOLECULAR PATTERNS RELEASING IN A NEW BLUNT LIVER INJURY MODEL IN MICE

佐々木 淳一

SHOCK 46 （ 4 ） 51 - 52 2016年10月

研究論文（学術雑誌）,  ISSN  1073-2322

The international activities in Taiwan by the joint burn care assistance team of physicians from Japan medical association and three medical societies

Matsuda Naoyuki, Yamada Sachiko, Hinoshita Takuga, Sasaki Junichi, Ikeda Hiroto, Harunari Nobuyuki, Sakamoto Tetsuya

Japan Medical Association Journal 59 （ 1 ） 12 - 16 2016年07月

ISSN  1346-8650

CAN EARLY AGGRESSIVE ADMINISTRATION OF FRESH FROZEN PLASMA IMPROVE OUTCOMES IN PATIENTS WITH SEVERE BLUNT TRAUMA?-A REPORT BY THE JAPANESE ASSOCIATION FOR THE SURGERY OF TRAUMA

佐々木 淳一

SHOCK 45 （ 5 ） 495 - 501 2016年05月

研究論文（学術雑誌）,  ISSN  1073-2322

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Development of Novel Criteria of the “Lethal Triad” as an Indicator of Decision Making in Current Trauma Care

Endo Akira, Shiraishi Atsushi, Otomo Yasuhiro, Kushimoto Shigeki, Saitoh Daizoh, Hayakawa Mineji, Ogura Hiroshi, Murata Kiyoshi, Hagiwara Akiyoshi, Sasaki Junichi, Matsuoka Tetsuya, Uejima Toshifumi, Morimura Naoto, Ishikura Hiroyasu, Takeda Munekazu, Kaneko Naoyuki, Kato Hiroshi, Kudo Daisuke, Kanemura Takashi, Shibusawa Takayuki, Hagiwara Yasushi, Furugori Shintaro, Nakamura Yoshihiko, Maekawa Kunihiko, Mayama Gou, Yaguchi Arino, Kim Shiei, Takasu Osamu, Nishiyama Kazutaka

Critical Care Medicine 2016年04月

ISSN  0090-3493

　概要を見る

<p>OBJECTIVES:: To evaluate the utility of the conventional lethal triad in current trauma care practice and to develop novel criteria as indicators of treatment strategy. DESIGN:: Retrospective observational study. SETTINGS:: Fifteen acute critical care medical centers in Japan. PATIENTS:: In total, 796 consecutive trauma patients who were admitted to emergency departments with an injury severity score of greater than or equal to 16 from January 2012 to December 2012. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: All data were retrospectively collected, including laboratory data on arrival. Sensitivities to predict trauma death within 28 days of prothrombin time international normalized ratio greater than 1.50, pH less than 7.2, and body temperature less than 35°C were 15.7%, 17.5%, and 15.9%, respectively, and corresponding specificities of these were 96.4%, 96.6%, and 93.6%, respectively. The best predictors associated with hemostatic disorder and acidosis were fibrin/fibrinogen degradation product and base excess (the cutoff values were 88.8 and –3.05 mmol/L). The optimal cutoff value of hypothermia was 36.0°C. The impact of the fibrin/fibrinogen degradation product and base excess abnormality on the outcome were approximately three- and two-folds compared with those of hypothermia. Using these variables, if the patient had a hemostatic disorder alone or a combined disorder with acidosis and hypothermia, the sensitivity and specificity were 80.7% and 66.8%. CONCLUSIONS:: Because of the low sensitivity and high specificity, conventional criteria were unsuitable as prognostic indicators. Our revised criteria are assumed to be useful for predicting trauma death and have the potential to be the objective indicators for activating the damage control strategy in early trauma care.</p>

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HIGH D-DIMER LEVELS PREDICT A POOR OUTCOME IN PATIENTS WITH SEVERE TRAUMA, EVEN WITH HIGH FIBRINOGEN LEVELS ON ARRIVAL A MULTICENTER RETROSPECTIVE STUDY

佐々木 淳一

SHOCK 45 （ 3 ） 308 - 314 2016年03月

研究論文（学術雑誌）,  ISSN  1073-2322

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