多村　知剛 （タムラ　トモヨシ）

Tamura, Tomoyoshi

写真a

所属（所属キャンパス）

医学部 救急医学教室 （信濃町）

職名

助教（有期）

外部リンク
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学歴 【 表示 ／ 非表示 】

  • 2001年04月
    -
    2007年03月

    慶應義塾大学

    大学, 卒業

  • 2016年04月
    -
    2019年03月

    慶應義塾大学

    大学院, 卒業, 博士

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学位 【 表示 ／ 非表示 】

  • 学士, 慶應義塾大学, 課程, 2007年03月

  • 博士（医学）, 慶應義塾大学, 課程, 2019年03月

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免許・資格 【 表示 ／ 非表示 】

  • 医師免許, 2007年04月

  • 救急科専門医, 2014年01月

  • 総合内科専門医, 2017年12月

  • 救急科指導医, 2024年01月

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研究分野 【 表示 ／ 非表示 】

  • ライフサイエンス / 救急医学

  • ライフサイエンス / 免疫学

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研究キーワード 【 表示 ／ 非表示 】

  • 心停止

  • 蘇生

  • ショック

  • 水素吸入

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論文 【 表示 ／ 非表示 】

  • Combination of Hydrogen Inhalation and Hypothermic Temperature Control after Out-of-Hospital Cardiac Arrest: A Post hoc Analysis of the Efficacy of Inhaled Hydrogen on Neurologic Outcome Following Brain Ischemia during PostCardiac Arrest Care II Trial

    Tamura T., Narumiya H., Homma K., Suzuki M., Iizuka R., Narimiya H., Tsuruta R., Kaneda K., Fujita M., Sasaki J., Akasaka O., Sawai K., Nozaki M., Imai H., Ishikura K., Ikejiri K., Kakihana Y., Niiyama S., Futatsuki T., Honda M., Ikeda Y., Oka H., Yoshihara H., Onishi H., Yamashita S., Shimizu K., Sakurai T., Yamada S., Fukami H., Shime N., Suzuki K., Kuroda Y., Kawakita K., Kimura A., Uemura T., Takuma K., Kanao K., Yanagawa Y., Takeuchi I.

    Critical Care Medicine 52 （ 10 ） 1567 - 1576 2024年10月

    ISSN  00903493

    　概要を見る

    OBJECTIVE: The Efficacy of Inhaled Hydrogen on Neurologic Outcome Following Brain Ischemia During Post-Cardiac Arrest Care (HYBRID) II trial (jRCTs031180352) suggested that hydrogen inhalation may reduce post-cardiac arrest brain injury (PCABI). However, the combination of hypothermic target temperature management (TTM) and hydrogen inhalation on outcomes is unclear. The aim of this study was to investigate the combined effect of hydrogen inhalation and hypothermic TTM on outcomes after out-of-hospital cardiac arrest (OHCA). DESIGN: Post hoc analysis of a multicenter, randomized, controlled trial. SETTING: Fifteen Japanese ICUs. PATIENTS: Cardiogenic OHCA enrolled in the HYBRID II trial. INTERVENTIONS: Hydrogen mixed oxygen (hydrogen group) versus oxygen alone (control group). MEASUREMENTS AND MAIN RESULTS: TTM was performed at a target temperature of 32-34°C (TTM32-TTM34) or 35-36°C (TTM35-TTM36) per the institutional protocol. The association between hydrogen + TTM32-TTM34 and 90-day good neurologic outcomes was analyzed using generalized estimating equations. The 90-day survival was compared between the hydrogen and control groups under TTM32-TTM34 and TTM35-TTM36, respectively. The analysis included 72 patients (hydrogen [n = 39] and control [n = 33] groups) with outcome data. TTM32-TTM34 was implemented in 25 (64%) and 24 (73%) patients in the hydrogen and control groups, respectively (p = 0.46). Under TTM32-TTM34, 17 (68%) and 9 (38%) patients achieved good neurologic outcomes in the hydrogen and control groups, respectively (relative risk: 1.81 [95% CI, 1.05-3.66], p < 0.05). Hydrogen + TTM32-TTM34 was independently associated with good neurologic outcomes (adjusted odds ratio 16.10 [95% CI, 1.88-138.17], p = 0.01). However, hydrogen + TTM32-TTM34 did not improve survival compared with TTM32-TTM34 alone (adjusted hazard ratio: 0.22 [95% CI, 0.05-1.06], p = 0.06). CONCLUSIONS: Hydrogen + TTM32-TTM34 was associated with improved neurologic outcomes after cardiogenic OHCA compared with TTM32-TTM34 monotherapy. Hydrogen inhalation is a promising treatment option for reducing PCABI when combined with TTM32-TTM34.

  • The association between mechanical CPR and outcomes from in-hospital cardiac arrest: An observational cohort study

    Crowley C., Salciccioli J., Wang W., Tamura T., Kim E.Y., Moskowitz A.

    Resuscitation 198 2024年05月

    ISSN  03009572

    　概要を見る

    Aim: We sought to investigate the relationship between mechanical cardiopulmonary resuscitation (CPR) during in-hospital cardiac arrest and survival to hospital discharge. Methods: Utilizing the prospectively collected American Heart Association's Get With The Guidelines database, we performed an observational study. Data from 153 institutions across the United States were reviewed with a total of 351,125 patients suffering cardiac arrest between 2011 and 2019 were screened. After excluding patients with cardiac arrests lasting less than 5 minutes, and patients who had incomplete data, a total of 111,143 patients were included. Our primary exposure was mechanical vs. manual CPR, and the primary outcome was survival to hospital discharge. Multivariate logistic regression models and propensity weighted analyses were used. Results: 11.8% of patients who received mechanical CPR survived to hospital discharge versus 16.9% in the manual CPR group. Patients who received mechanical CPR had a lower probability of survival to discharge compared to patients who received manual CPR (OR 0.66 95% CI 0.58–0.75; p < 0.001). This association persisted with multi-variable adjustment (OR 0.57 95% CI 0.46–0.70, p < 0.0001) and propensity weighted analysis (OR 0.68 95% CI 0.44–0 0.92, p < 0.0001). Mechanical CPR was associated with decrease likelihood of return of spontaneous circulation after multivariate adjustment (OR 0.68, 95% CI 0.60–0.76; p < 0.001). Conclusions: Mechanical CPR was associated with a decreased likelihood of survival to hospital discharge and ROSC compared to manual CPR. This finding should be interpreted within the context of important limitations of this study and randomized trials are needed to better investigate this relationship.

  • Protocol for immunophenotyping out-of-hospital cardiac arrest patients

    Yamada K., Menon J.A., Kim Y., Cheng C., Chen W., Shih J.A., Villasenor-Altamirano A.B., Chen X., Tamura T., Merriam L.T., Kim E.Y., Weissman A.J.

    STAR Protocols 5 （ 1 ）  2024年03月

    　概要を見る

    Immunophenotyping of out-of-hospital cardiac arrest (OHCA) patients is of increasing interest but has challenges. Here, we describe steps for the design of the clinical cohort, planning patient enrollment and sample collection, and ethical review of the study protocol. We detail procedures for blood sample collection and cryopreservation of peripheral blood mononuclear cells (PBMCs). We detail steps to modulate immune checkpoints in OHCA PBMC ex vivo. This protocol also has relevance for immunophenotyping other types of critical illness. For complete details on the use and execution of this protocol, please refer to Tamura et al. (2023).1

  • Wolf Creek XVII Part 8: Neuroprotection

    Hirsch K.G., Tamura T., Ristagno G., Sekhon M.S.

    Resuscitation Plus 17 2024年03月

    　概要を見る

    Introduction: Post-cardiac arrest brain injury (PCABI) is the primary determinant of clinical outcomes for patients who achieve return of spontaneous circulation after cardiac arrest (CA). There are limited neuroprotective therapies available to mitigate the acute pathophysiology of PCABI. Methods: Neuroprotection was one of six focus topics for the Wolf Creek XVII Conference held on June 14–17, 2023 in Ann Arbor, Michigan, USA. Conference invitees included international thought leaders and scientists in the field of CA resuscitation from academia and industry. Participants submitted via online survey knowledge gaps, barriers to translation, and research priorities for each focus topic. Expert panels used the survey results and their own perspectives and insights to create and present a preliminary unranked list for each category that was debated, revised and ranked by all attendees to identify the top 5 for each category. Results: Top 5 knowledge gaps included developing therapies for neuroprotection; improving understanding of the pathophysiology, mechanisms, and natural history of PCABI; deploying precision medicine approaches; optimizing resuscitation and CPR quality; and determining optimal timing for and duration of interventions. Top 5 barriers to translation included patient heterogeneity; nihilism & lack of knowledge about cardiac arrest; challenges with the translational pipeline; absence of mechanistic biomarkers; and inaccurate neuro-triage and neuroprognostication. Top 5 research priorities focused on translational research and trial optimization; addressing patient heterogeneity and individualized interventions; improving understanding of pathophysiology and mechanisms; developing mechanistic and outcome biomarkers across post-CA time course; and improving implementation of science and technology. Conclusion: This overview can serve as a guide to transform the care and outcome of patients with PCABI. Addressing these topics has the potential to improve both research and clinical care in the field of neuroprotection for PCABI.

  • Establishment and application of a new 4/6 infarct nephrectomy rat model for moderate chronic kidney disease

    Sugai K., Hirano M., Oda A., Fujisawa M., Shono S., Ishioka K., Tamura T., Katsumata Y., Sano M., Kobayashi E., Hakamata Y.

    Acta Cirurgica Brasileira 39 2024年

    ISSN  01028650

    　概要を見る

    Purpose: To develop a new 4/6 infarct nephrectomy (INx) model rat mimicking moderate chronic kidney disease (CKD) and to evaluate its application. Methods: We modified the conventional 5/6 INx rat model to create the 4/6 INx model by ligating the renal artery branch to induce infarction of one-third of the left kidney after right kidney removal and compared biochemically and histologically both models. To demonstrate the application of the 4/6 INx model, the effects of a supplementary compound containing calcium carbonate, chitosan, palm shell activated charcoal etc., that is effective for both CKD and its complications, were compared between both models. Results: Impairment of renal function in the 4/6 INx group was significantly more moderate than in the 5/6 INx group (P < 0.05). The 4/6 INx group showed less histological damage in kidney than in the 5/6 INx group. The supplementary compound did not improve CKD in the 5/6 INx group, but ameliorated elevation of blood urea nitrogen in the 4/6 INx group. Conclusion: We developed the 4/6 INx model, which is more moderate than the conventional 5/6 INx model. This model could potentially demonstrate the effectiveness of drugs and supplements intended to prevent CKD and its progression.

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競争的研究費の研究課題 【 表示 ／ 非表示 】

  • 水素によるフェロトーシス抑制機構の解明と水素吸入療法の最適化

    2024年04月
    -
    2027年03月

    多村 知剛, 基盤研究(C), 補助金,  研究代表者

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