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1. Early restricted oxygen therapy after resuscitation from cardiac arrest (ER-OXYTRAC): protocol for a stepped-wedge cluster randomised controlled trial

Author

Kazuma Yamakawa, Yasunori Sato, Takashi Tagami, Akira Endo, Hirofumi Nakayama, Takeshi Wada, Masayuki Yagi, Takeshi Yamagiwa, Shinichi Iizuka, Daiki Kaito, Naoya Miura, Ryo Takemura, Kota Shinada, Ginga Suzuki, Keiki Shimizu, Eisei Hoshiyama, Saori Kurata, Ryo Yamamoto, Koichiro Homma, Taku Yonemura, Takayuki Shibusawa, Takahiro Shoji, Jiro Takahashi, Chihiro Narita, Kazunobu Minami, Yoshihisa Fujinami, Yohei Tsubouchi, Mai Natsukawa, Jun Nagayama, Wataru Takayama, Ken Ishikura, Kyoko Yokokawa, Yasuo Fujita, Hideki Tokuyama, Takayuki Taira, Shoki Fukui, Noritaka Ushio, Masaki Nakane, Akihito Tampo, Hisako Sageshima, Hiroki Takami, Hitoshi Kikuchi, Jun Hagiwara, Yumi Funato, Junichi Sasaki, and study group ER-OXYTRAC

Subjects
Medicine
Abstract

Introduction Cardiac arrest is a critical condition, and patients often experience postcardiac arrest syndrome (PCAS) even after the return of spontaneous circulation (ROSC). Administering a restricted amount of oxygen in the early phase after ROSC has been suggested as a potential therapy for PCAS; however, the optimal target for arterial partial pressure of oxygen or peripheral oxygen saturation (SpO2) to safely and effectively reduce oxygen remains unclear. Therefore, we aimed to validate the efficacy of restricted oxygen treatment with 94%–95% of the target SpO2 during the initial 12 hours after ROSC for patients with PCAS.Methods and analysis ER-OXYTRAC (early restricted oxygen therapy after resuscitation from cardiac arrest) is a nationwide, multicentre, pragmatic, single-blind, stepped-wedge cluster randomised controlled trial targeting cases of non-traumatic cardiac arrest. This study includes adult patients with out-of-hospital or in-hospital cardiac arrest who achieved ROSC in 39 tertiary centres across Japan, with a target sample size of 1000. Patients whose circulation has returned before hospital arrival and those with cardiac arrest due to intracranial disease or intoxication are excluded. Study participants are assigned to either the restricted oxygen (titration of a fraction of inspired oxygen with 94%–95% of the target SpO2) or the control (98%–100% of the target SpO2) group based on cluster randomisation per institution. The trial intervention continues until 12 hours after ROSC. Other treatments for PCAS, including oxygen administration later than 12 hours, can be determined by the treating physicians. The primary outcome is favourable neurological function, defined as cerebral performance category 1–2 at 90 days after ROSC, to be compared using an intention-to-treat analysis.Ethics and dissemination This study has been approved by the Institutional Review Board at Keio University School of Medicine (approval number: 20211106). Written informed consent will be obtained from all participants or their legal representatives. Results will be disseminated via publications and presentations.Trial registration number UMIN Clinical Trials Registry (UMIN000046914).

Published
2023
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2. The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

Author

Qingbo S. Wang, Ryuya Edahiro, Ho Namkoong, Takanori Hasegawa, Yuya Shirai, Kyuto Sonehara, Hiromu Tanaka, Ho Lee, Ryunosuke Saiki, Takayoshi Hyugaji, Eigo Shimizu, Kotoe Katayama, Masahiro Kanai, Tatsuhiko Naito, Noah Sasa, Kenichi Yamamoto, Yasuhiro Kato, Takayoshi Morita, Kazuhisa Takahashi, Norihiro Harada, Toshio Naito, Makoto Hiki, Yasushi Matsushita, Haruhi Takagi, Masako Ichikawa, Ai Nakamura, Sonoko Harada, Yuuki Sandhu, Hiroki Kabata, Katsunori Masaki, Hirofumi Kamata, Shinnosuke Ikemura, Shotaro Chubachi, Satoshi Okamori, Hideki Terai, Atsuho Morita, Takanori Asakura, Junichi Sasaki, Hiroshi Morisaki, Yoshifumi Uwamino, Kosaku Nanki, Sho Uchida, Shunsuke Uno, Tomoyasu Nishimura, Takashri Ishiguro, Taisuke Isono, Shun Shibata, Yuma Matsui, Chiaki Hosoda, Kenji Takano, Takashi Nishida, Yoichi Kobayashi, Yotaro Takaku, Noboru Takayanagi, Soichiro Ueda, Ai Tada, Masayoshi Miyawaki, Masaomi Yamamoto, Eriko Yoshida, Reina Hayashi, Tomoki Nagasaka, Sawako Arai, Yutaro Kaneko, Kana Sasaki, Etsuko Tagaya, Masatoshi Kawana, Ken Arimura, Kunihiko Takahashi, Tatsuhiko Anzai, Satoshi Ito, Akifumi Endo, Yuji Uchimura, Yasunari Miyazaki, Takayuki Honda, Tomoya Tateishi, Shuji Tohda, Naoya Ichimura, Kazunari Sonobe, Chihiro Tani Sassa, Jun Nakajima, Yasushi Nakano, Yukiko Nakajima, Ryusuke Anan, Ryosuke Arai, Yuko Kurihara, Yuko Harada, Kazumi Nishio, Tetsuya Ueda, Masanori Azuma, Ryuichi Saito, Toshikatsu Sado, Yoshimune Miyazaki, Ryuichi Sato, Yuki Haruta, Tadao Nagasaki, Yoshinori Yasui, Yoshinori Hasegawa, Yoshikazu Mutoh, Tomoki Kimura, Tomonori Sato, Reoto Takei, Satoshi Hagimoto, Yoichiro Noguchi, Yasuhiko Yamano, Hajime Sasano, Sho Ota, Yasushi Nakamori, Kazuhisa Yoshiya, Fukuki Saito, Tomoyuki Yoshihara, Daiki Wada, Hiromu Iwamura, Syuji Kanayama, Shuhei Maruyama, Takashi Yoshiyama, Ken Ohta, Hiroyuki Kokuto, Hideo Ogata, Yoshiaki Tanaka, Kenichi Arakawa, Masafumi Shimoda, Takeshi Osawa, Hiroki Tateno, Isano Hase, Shuichi Yoshida, Shoji Suzuki, Miki Kawada, Hirohisa Horinouchi, Fumitake Saito, Keiko Mitamura, Masao Hagihara, Junichi Ochi, Tomoyuki Uchida, Rie Baba, Daisuke Arai, Takayuki Ogura, Hidenori Takahashi, Shigehiro Hagiwara, Genta Nagao, Shunichiro Konishi, Ichiro Nakachi, Koji Murakami, Mitsuhiro Yamada, Hisatoshi Sugiura, Hirohito Sano, Shuichiro Matsumoto, Nozomu Kimura, Yoshinao Ono, Hiroaki Baba, Yusuke Suzuki, Sohei Nakayama, Keita Masuzawa, Shinichi Namba, Takayuki Shiroyama, Yoshimi Noda, Takayuki Niitsu, Yuichi Adachi, Takatoshi Enomoto, Saori Amiya, Reina Hara, Yuta Yamaguchi, Teruaki Murakami, Tomoki Kuge, Kinnosuke Matsumoto, Yuji Yamamoto, Makoto Yamamoto, Midori Yoneda, Kazunori Tomono, Kazuto Kato, Haruhiko Hirata, Yoshito Takeda, Hidefumi Koh, Tadashi Manabe, Yohei Funatsu, Fumimaro Ito, Takahiro Fukui, Keisuke Shinozuka, Sumiko Kohashi, Masatoshi Miyazaki, Tomohisa Shoko, Mitsuaki Kojima, Tomohiro Adachi, Motonao Ishikawa, Kenichiro Takahashi, Takashi Inoue, Toshiyuki Hirano, Keigo Kobayashi, Hatsuyo Takaoka, Kazuyoshi Watanabe, Naoki Miyazawa, Yasuhiro Kimura, Reiko Sado, Hideyasu Sugimoto, Akane Kamiya, Naota Kuwahara, Akiko Fujiwara, Tomohiro Matsunaga, Yoko Sato, Takenori Okada, Yoshihiro Hirai, Hidetoshi Kawashima, Atsuya Narita, Kazuki Niwa, Yoshiyuki Sekikawa, Koichi Nishi, Masaru Nishitsuji, Mayuko Tani, Junya Suzuki, Hiroki Nakatsumi, Takashi Ogura, Hideya Kitamura, Eri Hagiwara, Kota Murohashi, Hiroko Okabayashi, Takao Mochimaru, Shigenari Nukaga, Ryosuke Satomi, Yoshitaka Oyamada, Nobuaki Mori, Tomoya Baba, Yasutaka Fukui, Mitsuru Odate, Shuko Mashimo, Yasushi Makino, Kazuma Yagi, Mizuha Hashiguchi, Junko Kagyo, Tetsuya Shiomi, Satoshi Fuke, Hiroshi Saito, Tomoya Tsuchida, Shigeki Fujitani, Mumon Takita, Daiki Morikawa, Toru Yoshida, Takehiro Izumo, Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Mari Tone, Akihiro Ito, Yoshihiko Nakamura, Kota Hoshino, Junichi Maruyama, Hiroyasu Ishikura, Tohru Takata, Toshio Odani, Masaru Amishima, Takeshi Hattori, Yasuo Shichinohe, Takashi Kagaya, Toshiyuki Kita, Kazuhide Ohta, Satoru Sakagami, Kiyoshi Koshida, Kentaro Hayashi, Tetsuo Shimizu, Yutaka Kozu, Hisato Hiranuma, Yasuhiro Gon, Namiki Izumi, Kaoru Nagata, Ken Ueda, Reiko Taki, Satoko Hanada, Kodai Kawamura, Kazuya Ichikado, Kenta Nishiyama, Hiroyuki Muranaka, Kazunori Nakamura, Naozumi Hashimoto, Keiko Wakahara, Sakamoto Koji, Norihito Omote, Akira Ando, Nobuhiro Kodama, Yasunari Kaneyama, Shunsuke Maeda, Takashige Kuraki, Takemasa Matsumoto, Koutaro Yokote, Taka-Aki Nakada, Ryuzo Abe, Taku Oshima, Tadanaga Shimada, Masahiro Harada, Takeshi Takahashi, Hiroshi Ono, Toshihiro Sakurai, Takayuki Shibusawa, Yoshifumi Kimizuka, Akihiko Kawana, Tomoya Sano, Chie Watanabe, Ryohei Suematsu, Hisako Sageshima, Ayumi Yoshifuji, Kazuto Ito, Saeko Takahashi, Kota Ishioka, Morio Nakamura, Makoto Masuda, Aya Wakabayashi, Hiroki Watanabe, Suguru Ueda, Masanori Nishikawa, Yusuke Chihara, Mayumi Takeuchi, Keisuke Onoi, Jun Shinozuka, Atsushi Sueyoshi, Yoji Nagasaki, Masaki Okamoto, Sayoko Ishihara, Masatoshi Shimo, Yoshihisa Tokunaga, Yu Kusaka, Takehiko Ohba, Susumu Isogai, Aki Ogawa, Takuya Inoue, Satoru Fukuyama, Yoshihiro Eriguchi, Akiko Yonekawa, Keiko Kan-o, Koichiro Matsumoto, Kensuke Kanaoka, Shoichi Ihara, Kiyoshi Komuta, Yoshiaki Inoue, Shigeru Chiba, Kunihiro Yamagata, Yuji Hiramatsu, Hirayasu Kai, Koichiro Asano, Tsuyoshi Oguma, Yoko Ito, Satoru Hashimoto, Masaki Yamasaki, Yu Kasamatsu, Yuko Komase, Naoya Hida, Takahiro Tsuburai, Baku Oyama, Minoru Takada, Hidenori Kanda, Yuichiro Kitagawa, Tetsuya Fukuta, Takahito Miyake, Shozo Yoshida, Shinji Ogura, Shinji Abe, Yuta Kono, Yuki Togashi, Hiroyuki Takoi, Ryota Kikuchi, Shinichi Ogawa, Tomouki Ogata, Shoichiro Ishihara, Arihiko Kanehiro, Shinji Ozaki, Yasuko Fuchimoto, Sae Wada, Nobukazu Fujimoto, Kei Nishiyama, Mariko Terashima, Satoru Beppu, Kosuke Yoshida, Osamu Narumoto, Hideaki Nagai, Nobuharu Ooshima, Mitsuru Motegi, Akira Umeda, Kazuya Miyagawa, Hisato Shimada, Mayu Endo, Yoshiyuki Ohira, Masafumi Watanabe, Sumito Inoue, Akira Igarashi, Masamichi Sato, Hironori Sagara, Akihiko Tanaka, Shin Ohta, Tomoyuki Kimura, Yoko Shibata, Yoshinori Tanino, Takefumi Nikaido, Hiroyuki Minemura, Yuki Sato, Yuichiro Yamada, Takuya Hashino, Masato Shinoki, Hajime Iwagoe, Hiroshi Takahashi, Kazuhiko Fujii, Hiroto Kishi, Masayuki Kanai, Tomonori Imamura, Tatsuya Yamashita, Masakiyo Yatomi, Toshitaka Maeno, Shinichi Hayashi, Mai Takahashi, Mizuki Kuramochi, Isamu Kamimaki, Yoshiteru Tominaga, Tomoo Ishii, Mitsuyoshi Utsugi, Akihiro Ono, Toru Tanaka, Takeru Kashiwada, Kazue Fujita, Yoshinobu Saito, Masahiro Seike, Hiroko Watanabe, Hiroto Matsuse, Norio Kodaka, Chihiro Nakano, Takeshi Oshio, Takatomo Hirouchi, Shohei Makino, Moritoki Egi, Yosuke Omae, Yasuhito Nannya, Takafumi Ueno, Tomomi Takano, Kazuhiko Katayama, Masumi Ai, Atsushi Kumanogoh, Toshiro Sato, Naoki Hasegawa, Katsushi Tokunaga, Makoto Ishii, Ryuji Koike, Yuko Kitagawa, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga, and Yukinori Okada

Subjects
Science
Abstract

Genetic mechanisms influencing COVID-19 susceptibility are not well understood. Here, the authors analyzed whole blood RNA-seq data of 465 Japanese individuals with COVID-19, highlighting thousands of fine-mapped variants affecting expression and splicing of genes, as well as the presence of COVID-19 severity-interaction eQTLs.

Published
2022
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3. Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients

Author

Shigeto Ishikawa, Yuto Teshima, Hiroki Otsubo, Takashi Shimazui, Taka-aki Nakada, Osamu Takasu, Kenichi Matsuda, Junichi Sasaki, Masakazu Nabeta, Takeshi Moriguchi, Takayuki Shibusawa, Toshihiko Mayumi, and Shigeto Oda

Subjects
Critically ill, Interleukin, Multiple organ dysfunction, Predictive marker, qSOFA, Special situations and conditions, RC952-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Shock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA). Methods This was a multicenter observational sub-study. Five universities from 2016 to 2018. Data of adult patients with systemic inflammatory response syndrome who presented to the emergency department or were admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10, tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The primary outcome was set as MOD on Day 2, and the area under the curve (AUC) was analyzed to evaluate qSOFA scores and biomarker levels. Results Of 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse prognosis, including mortality. The AUC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95% confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI: 0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.842 [95% CI: 0.771–0.893]). The combination model using qSOFA (Day 1) and IL-6 (Day 1) also showed a higher AUC (0.868 [95% CI: 0.799–0.915]). The combination model of IL-8 and PCT also showed a significant improvement in AUC. Conclusions The addition of IL-6, IL-8 and PCT to qSOFA scores improved the accuracy of early MOD prediction.

Published
2021
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4. Japanese Society for Burn Injuries (JSBI) Clinical Practice Guidelines for Management of Burn Care (3rd Edition)

Author

Junichi Sasaki, Asako Matsushima, Hiroto Ikeda, Yoshiaki Inoue, Jiro Katahira, Miyuki Kishibe, Chu Kimura, Yukio Sato, Kiyotsugu Takuma, Katsumi Tanaka, Minoru Hayashi, Hajime Matsumura, Hiroshi Yasuda, Yuya Yoshimura, Hiromichi Aoki, Yoshihisa Ishizaki, Nobuo Isono, Takahiro Ueda, Kazuya Umezawa, Akinori Osuka, Takayuki Ogura, Yasuhiko Kaita, Katsuya Kawai, Kyoko Kawamoto, Masahiko Kimura, Takatsugu Kubo, Tomohiro Kurihara, Masato Kurokawa, Shuken Kobayashi, Daizoh Saitoh, Ryuji Shichinohe, Takayuki Shibusawa, Yuya Suzuki, Kazutaka Soejima, Ichiro Hashimoto, Osamu Fujiwara, Hiroshi Matsuura, Kazumasa Miida, Michiteru Miyazaki, Naoki Murao, Wataru Morikawa, and Sachiko Yamada

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

The Japanese Society for Burn Injuries (JSBI) published the third edition of guidelines to present the standard of care for inpatient treatment of burn injuries in Japan. The guideline is not a mere revision of the first and second editions but has been carefully designed to be user friendly and of high quality for medical professionals engaged in burn care. We think it is important to share these guidelines with other countries to work toward a consensus of burn care, then develop new research to establish evidence for burn care and treatment in the future.

Published
2022
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5. Accuracy for Mortality Prediction With Additive Biomarkers Including Interleukin-6 in Critically Ill Patients: A Multicenter Prospective Observational Study

Author

Ryo Yamamoto, MD, Junichi Sasaki, MD, Takayuki Shibusawa, MD, Taka-aki Nakada, MD, Toshihiko Mayumi, MD, Osamu Takasu, MD, Kenichi Matsuda, MD, Takashi Shimazui, MD, Hiroki Otsubo, MD, Yuto Teshima, MD, Masakazu Nabeta, MD, Takeshi Moriguchi, MD, and Shigeto Oda, MD

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objectives:. Several inflammation markers have been reported to be associated with unfavorable clinical outcomes in critically ill patients. We aimed to elucidate whether serum interleukin-6 concentration considered with Sequential Organ Failure Assessment score can better predict mortality in critically ill patients. Design:. A prospective observational study. Setting:. Five university hospitals in 2016–2018. Patients:. Critically ill adult patients who met greater than or equal to two systemic inflammatory response syndrome criteria at admission were included, and those who died or were discharged within 48 hours were excluded. Interventions:. Inflammatory biomarkers including interleukin (interleukin)–6, -8, and -10; tumor necrosis factor–α; C-reactive protein; and procalcitonin were blindly measured daily for 3 days. Area under the receiver operating characteristic curve for Sequential Organ Failure Assessment score at day 2 according to 28-day mortality was calculated as baseline. Combination models of Sequential Organ Failure Assessment score and additional biomarkers were developed using logistic regression, and area under the receiver operating characteristic curve calculated in each model was compared with the baseline. Measurements and Main Results:. Among 161 patients included in the study, 18 (11.2%) did not survive at day 28. Univariate analysis for each biomarker identified that the interleukin-6 (days 1–3), interleukin-8 (days 0–3), and interleukin-10 (days 1–3) were higher in nonsurvivors than in survivors. Analyses of 28-day mortality prediction by a single biomarker showed interleukin-6, -8, and -10 at days 1–3 had a significant discrimination power, and the interleukin-6 at day 3 had the highest area under the receiver operating characteristic curve (0.766 [0.656–0.876]). The baseline area under the receiver operating characteristic curve for Sequential Organ Failure Assessment score predicting 28-day mortality was 0.776 (0.672–0.880). The combination model using additional interleukin-6 at day 3 had higher area under the receiver operating characteristic curve than baseline (area under the receiver operating characteristic curve = 0.844, area under the receiver operating characteristic curve improvement = 0.068 [0.002–0.133]), whereas other biomarkers did not improve accuracy in predicting 28-day mortality. Conclusions:. Accuracy for 28-day mortality prediction was improved by adding serum interleukin-6 concentration to Sequential Organ Failure Assessment score.

Published
2021
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6. Optimal tentative abdominal closure for open abdomen: a multicenter retrospective observational study (OPTITAC study).

Author

Ryo Yamamoto, Shunsuke Kuramoto, Masayuki Shimizu, Hiroharu Shinozaki, Tasuku Miyake, Yoshihiko Sadakari, Kazuhiko Sekine, Yasushi Kaneko, Ryo Kurosaki, Kiyoshi Koizumi, Takayuki Shibusawa, Yoshihiko Sakurai, Sota Wakahara, and Junichi Sasaki

Abstract

Background: Primary fascia closure is often difficult following an open abdomen (OA). While negative-pressure wound therapy (NPWT) is recommended to enhance successful primary fascia closure, the optimal methods and degree of negative pressure remain unclear. This study aimed to elucidate optimal methods of NPWT as a tentative abdominal closure for OA to achieve primary abdominal fascia closure. Materials and Methods: A multicenter, retrospective, cohort study of adults who survived OA greater than 48 h was conducted in 12 institutions between 2010 and 2022. The achievement of primary fascia closure and incidence of enteroatmospheric fistula were examined based on methods (homemade, superficial NPWT kit, or open-abdomen kit) or degrees of negative pressure (<50, 50-100, or > 100 mmHg). A generalized estimating equation was used to adjust for age, BMI, comorbidities, etiology for laparotomy requiring OA, vital signs, transfusion, severity of critical illness, and institutional characteristics. Results: Of the 279 included patients, 252 achieved primary fascia closure. A higher degree of negative pressure (>100 mmHg) was associated with fewer primary fascia closures than less than 50 mmHg [OR, 0.18 (95% CI: 0.50-0.69), P =0.012] and with more frequent enteroatmospheric fistula [OR, 13.83 (95% CI: 2.30-82.93)]. The methods of NPWT were not associated with successful primary fascia closure. However, the use of the open-abdomen kit was related to a lower incidence of enteroatmospheric fistula [OR, 0.02 (95% CI: 0.00-0.50)]. Conclusion: High negative pressure (>100 mmHg) should be avoided in NPWT during tentative abdominal closure for OA. [ABSTRACT FROM AUTHOR]

Published
2023
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7. Relationship between the gravel species on the riverbed of the Arakawa River and the geology of the Chichibu region ─A proposal of teaching materials for stone education─

Author

Pingxing, Zhang and Takayuki, Shibusawa

Subjects
教育, 荒川, Arakawa river, geology, education, 秩父, 石材, 地質, Chichibu, gravel species, stone, 礫
Abstract

本研究は，関東地方有数の石材産地である秩父地方において，荒川上流の河原の礫種がどのように秩父地方の地質を反映しているかを把握することで，造園石材や建築石材の教材を提案することを目的とした。公共交通機関からアクセスでき，河原に降りて調査を実行可能な場所，かつ荒川の流路が湾曲し，礫が多く堆積している場所から6地点を選定した。それぞれ5mのひもを3回のばし，ひもに触れた長径5～20cmの礫を対象とした。「地質図Navi」から秩父地方の岩石の分布域を抽出し，石材に多用される岩石の種類をもとに3回調査した結果，6地点はいずれも砂岩類（緑色岩類を含む）・泥岩類が上位を占めており，花崗岩類・チャート・石灰岩・蛇紋岩・緑泥石片岩およびその他の結晶片岩類が認められた。6地点の礫種の変化は，支流上流の地質にも大きく影響されていると考えられる。また，人工護岸の有無や，礫の大きさや形状を左右する岩石自体の性質も，礫種の変化に影響を与えていると推察される。以上の6地点は石材教育の教材として，造園石材や建築石材に対する理解の向上，地域の石材と地質の関係性に対する理解の向上，調査スケジュールの高い自由度が期待できる。, The Chichibu region is one of the important stone-producing areas in the Kanto region. We aimed to propose teaching materials for the education of gardening stone and building stone, by understanding how the gravel species on the riverbed of the Arakawa River reflect the geology of the Chichibu region. We selected 6 sites on curved riverbed where public transportation is available, and where the Arakawa River is curved. On each site, a string of 5 m was pulled in 3 places and the gravel with a major axis of 5 to 20 cm that touched the string were recorded. After extracting the geological information from GeoNavi (GSJ/AIST), the investigation was conducted 3 times. As a result, sandstone (including greenstone) and mudstone occupied the top-level in 6 sites. Granite, chert, limestone, serpentinite, greenschist, and other crystalline schist were confirmed. It is considered that the changes in gravel species at the 6 sites are also affected by the upstream geology of the tributaries. In addition, the artificial revetments and the hardness of the rock also possibly affect the change of gravel species. The 6 sites can be scheduled conveniently, as teaching materials for the education of gardening stones and building stones, as well as the understanding of the relationship between the material regionality and geology.

Published
2022

8. Author response for 'Clinical significance of pre‐diabetes, undiagnosed diabetes, and diagnosed diabetes on clinical outcomes in COVID‐19: Integrative analysis from the Japan COVID‐19 Task Force'

Author

null Takahiro Fukushima, null Shotaro Chubachi, null Ho Namkoong, null Takanori Asakura, null Hiromu Tanaka, null Ho Lee, null Shuhei Azekawa, null Yukinori Okada, null Ryuji Koike, null Akinori Kimura, null Seiya Imoto, null Satoru Miyano, null Seishi Ogawa, null Takanori Kanai, null Koichi Fukunaga, null Shiro Otake, null Kensuke Nakagawara, null Atsuho Morita, null Mayuko Watase, null Kaori Sakurai, null Takuya Kusumoto, null Katsunori Masaki, null Hiroki Kabata, null Hirofumi Kamata, null Makoto Ishii, null Naoki Hasegawa, null Kazuhisa Takahashi, null Norihiro Harada, null Toshio Naito, null Makoto Hiki, null Yasushi Matsushita, null Haruhi Takagi, null Ryousuke Aoki, null Ai Nakamura, null Sonoko Harada, null Hitoshi Sasano, null Shinnosuke Ikemura, null Satoshi Okamori, null Hideki Terai, null Junichi Sasaki, null Hiroshi Morisaki, null Yoshifumi Uwamino, null Kosaku Nanki, null Yohei Mikami, null Sho Uchida, null Shunsuke Uno, null Rino Ishihara, null Yuta Matsubara, null Tomoyasu Nishimura, null Takunori Ogawa, null Toshiro Sato, null Tetsuya Ueda, null Masanori Azuma, null Ryuichi Saito, null Toshikatsu Sado, null Yoshimune Miyazaki, null Ryuichi Sato, null Yuki Haruta, null Tadao Nagasaki, null Yoshinori Yasui, null Yoshinori Hasegawa, null Soichiro Ueda, null Ai Tada, null Masayoshi Miyawaki, null Masaomi Yamamoto, null Eriko Yoshida, null Reina Hayashi, null Tomoki Nagasaka, null Sawako Arai, null Yutaro Kaneko, null Kana Sasaki, null Takashi Ishiguro, null Taisuke Isono, null Shun Shibata, null Yuma Matsui, null Chiaki Hosoda, null Kenji Takano, null Takashi Nishida, null Yoichi Kobayashi, null Yotaro Takaku, null Noboru Takayanagi, null Etsuko Tagaya, null Masatoshi Kawana, null Ken Arimura, null Yasushi Nakamori, null Kazuhisa Yoshiya, null Fukuki Saito, null Tomoyuki Yoshihara, null Daiki Wada, null Hiromu Iwamura, null Syuji Kanayama, null Shuhei Maruyama, null Takanori Hasegawa, null Kunihiko Takahashi, null Tatsuhiko Anzai, null Satoshi Ito, null Akifumi Endo, null Yuji Uchimura, null Yasunari Miyazaki, null Takayuki Honda, null Tomoya Tateishi, null Shuji Tohda, null Naoya Ichimura, null Kazunari Sonobe, null Chihiro Tani Sassa, null Jun Nakajima, null Masumi Ai, null Takashi Yoshiyama, null Ken Ohta, null Hiroyuki Kokuto, null Hideo Ogata, null Yoshiaki Tanaka, null Kenichi Arakawa, null Masafumi Shimoda, null Takeshi Osawa, null Yasushi Nakano, null Yukiko Nakajima, null Ryusuke Anan, null Ryosuke Arai, null Yuko Kurihara, null Yuko Harada, null Kazumi Nishio, null Yoshikazu Mutoh, null Tomonori Sato, null Reoto Takei, null Satoshi Hagimoto, null Yoichiro Noguchi, null Yasuhiko Yamano, null Hajime Sasano, null Sho Ota, null Yusuke Suzuki, null Sohei Nakayama, null Keita Masuzawa, null Tomomi Takano, null Kazuhiko Katayama, null Koji Murakami, null Mitsuhiro Yamada, null Hisatoshi Sugiura, null Hirohito Sano, null Shuichiro Matsumoto, null Nozomu Kimura, null Yoshinao Ono, null Hiroaki Baba, null Rie Baba, null Daisuke Arai, null Takayuki Ogura, null Hidenori Takahashi, null Shigehiro Hagiwara, null Genta Nagao, null Shunichiro Konishi, null Ichiro Nakachi, null Hiroki Tateno, null Isano Hase, null Shuichi Yoshida, null Shoji Suzuki, null Miki Kawada, null Hirohisa Horinouchi, null Fumitake Saito, null Keiko Mitamura, null Masao Hagihara, null Junichi Ochi, null Tomoyuki Uchida, null Ryuya Edahiro, null Yuya Shirai, null Kyuto Sonehara, null Tatsuhiko Naito, null Kenichi Yamamoto, null Shinichi Namba, null Ken Suzuki, null Takayuki Shiroyama, null Yuichi Maeda, null Takuro Nii, null Yoshimi Noda, null Takayuki Niitsu, null Yuichi Adachi, null Takatoshi Enomoto, null Saori Amiya, null Reina Hara, null Toshihiro Kishikawa, null Shuhei Yamada, null Shuhei Kawabata, null Noriyuki Kijima, null Masatoshi Takagaki, null Noa Sasa, null Yuya Ueno, null Motoyuki Suzuki, null Norihiko Takemoto, null Hirotaka Eguchi, null Takahito Fukusumi, null Takao Imai, null Munehisa Fukushima, null Haruhiko Kishima, null Hidenori Inohara, null Kazunori Tomono, null Kazuto Kato, null Haruhiko Hirata, null Yoshito Takeda, null Atsushi Kumanogoh, null Naoki Miyazawa, null Yasuhiro Kimura, null Reiko Sado, null Hideyasu Sugimoto, null Akane Kamiya, null Naota Kuwahara, null Akiko Fujiwara, null Tomohiro Matsunaga, null Yoko Sato, null Takenori Okada, null Takashi Inoue, null Toshiyuki Hirano, null Keigo Kobayashi, null Hatsuyo Takaoka, null Koichi Nishi, null Masaru Nishitsuji, null Mayuko Tani, null Junya Suzuki, null Hiroki Nakatsumi, null Hidefumi Koh, null Tadashi Manabe, null Yohei Funatsu, null Fumimaro Ito, null Takahiro Fukui, null Keisuke Shinozuka, null Sumiko Kohashi, null Masatoshi Miyazaki, null Tomohisa Shoko, null Mitsuaki Kojima, null Tomohiro Adachi, null Motonao Ishikawa, null Kenichiro Takahashi, null Kazuyoshi Watanabe, null Yoshihiro Hirai, null Hidetoshi Kawashima, null Atsuya Narita, null Kazuki Niwa, null Yoshiyuki Sekikawa, null Hisako Sageshima, null Yoshihiko Nakamura, null Kota Hoshino, null Junichi Maruyama, null Hiroyasu Ishikura, null Tohru Takata, null Takashi Ogura, null Hideya Kitamura, null Eri Hagiwara, null Kota Murohashi, null Hiroko Okabayashi, null Takao Mochimaru, null Shigenari Nukaga, null Ryosuke Satomi Yoshitaka Oyamada, null Nobuaki Mori, null Tomoya Baba, null Yasutaka Fukui, null Mitsuru Odate, null Shuko Mashimo, null Yasushi Makino, null Kazuma Yagi, null Mizuha Hashiguchi, null Junko Kagyo, null Tetsuya Shiomi, null Kodai Kawamura, null Kazuya Ichikado, null Kenta Nishiyama, null Hiroyuki Muranaka, null Kazunori Nakamura, null Satoshi Fuke, null Hiroshi Saito, null Tomoya Tsuchida, null Shigeki Fujitani, null Mumon Takita, null Daiki Morikawa, null Toru Yoshida, null Takehiro Izumo, null Minoru Inomata, null Naoyuki Kuse, null Nobuyasu Awano, null Mari Tone, null Akihiro Ito, null Toshio Odani, null Masaru Amishima, null Takeshi Hattori, null Yasuo Shichinohe, null Takashi Kagaya, null Toshiyuki Kita, null Kazuhide Ohta, null Satoru Sakagami, null Kiyoshi Koshida, null Morio Nakamura, null Koutaro Yokote, null Taka‐Aki Nakada, null Ryuzo Abe, null Taku Oshima, null Tadanaga Shimada, null Kentaro Hayashi, null Tetsuo Shimizu, null Yutaka Kozu, null Hisato Hiranuma, null Yasuhiro Gon, null Namiki Izumi, null Kaoru Nagata, null Ken Ueda, null Reiko Taki, null Satoko Hanada, null Naozumi Hashimoto, null Keiko Wakahara, null Koji Sakamoto, null Norihito Omote, null Akira Ando, null Yu Kusaka, null Takehiko Ohba, null Susumu Isogai, null Aki Ogawa, null Takuya Inoue, null Nobuhiro Kodama, null Yasunari Kaneyama, null Shunsuke Maeda, null Takashige Kuraki, null Takemasa Matsumoto, null Masahiro Harada, null Takeshi Takahashi, null Hiroshi Ono, null Toshihiro Sakurai, null Takayuki Shibusawa, null Yusuke Kawamura, null Akiyoshi Nakayama, null Hirotaka Matsuo, null Yoshifumi Kimizuka, null Akihiko Kawana, null Tomoya Sano, null Chie Watanabe, null Ryohei Suematsu, null Makoto Masuda, null Aya Wakabayashi, null Hiroki Watanabe, null Suguru Ueda, null Masanori Nishikawa Ayumi Yoshifuji, null Kazuto Ito, null Saeko Takahashi, null Kota Ishioka, null Yusuke Chihara, null Mayumi Takeuchi, null Keisuke Onoi, null Jun Shinozuka, null Atsushi Sueyoshi, null Yoji Nagasaki, null Masaki Okamoto, null Sayoko Ishihara, null Masatoshi Shimo, null Yoshihisa Tokunaga, null Masafumi Watanabe, null Sumito Inoue, null Akira Igarashi, null Masamichi Sato, null Nobuyuki Hizawa, null Yoshiaki Inoue, null Shigeru Chiba, null Kunihiro Yamagata, null Yuji Hiramatsu, null Hirayasu Kai, null Satoru Fukuyama, null Yoshihiro Eriguchi, null Akiko Yonekawa, null Keiko Kano, null Koichiro Matsumoto, null Kensuke Kanaoka, null Shoichi Ihara, null Kiyoshi Komuta, null Koichiro Asano, null Tsuyoshi Oguma, null Yoko Ito, null Satoru Hashimoto, null Masaki Yamasaki, null Yu Kasamatsu, null Yuko Komase, null Naoya Hida, null Takahiro Tsuburai, null Baku Oyama, null Yuichiro Kitagawa, null Tetsuya Fukuta, null Takahito Miyake, null Shozo Yoshida, null Shinji Ogura, null Minoru Takada, null Hidenori Kanda, null Shinji Abe, null Yuta Kono, null Yuki Togashi, null Hiroyuki Takoi, null Ryota Kikuchi, null Shinichi Ogawa, null Tomouki Ogata, null Shoichiro Ishihara, null Arihiko Kanehiro, null Shinji Ozaki, null Yasuko Fuchimoto, null Sae Wada, null Nobukazu Fujimoto, null Kei Nishiyama, null Mariko Terashima, null Satoru Beppu, null Kosuke Yoshida, null Osamu Narumoto, null Hideaki Nagai, null Nobuharu Ooshima, null Mitsuru Motegi, null Akira Umeda, null Kazuya Miyagawa, null Hisato Shimada, null Mayu Endo, null Yoshiyuki Ohira, null Hironori Sagara, null Akihiko Tanaka, null Shin Ohta, null Tomoyuki Kimura, null Yoko Shibata, null Yoshinori Tanino, null Takefumi Nikaido, null Hiroyuki Minemura, null Yuki Sato, null Yuichiro Yamada, null Takuya Hashino, null Masato Shinoki, null Hajime Iwagoe, null Hiroshi Takahashi, null Kazuhiko Fujii, null Hiroto Kishi, null Tomoo Ishii, null Masayuki Kanai, null Tomonori Imamura, null Tatsuya Yamashita, null Masakiyo Yatomi, null Toshitaka Maeno, null Shinichi Hayashi, null Mai Takahashi, null Mizuki Kuramochi, null Isamu Kamimaki, null Yoshiteru Tominaga, null Mitsuyoshi Utsugi, null Akihiro Ono, null Toru Tanaka, null Takeru Kashiwada, null Kazue Fujita, null Yoshinobu Saito, null Masahiro Seike, null Masahiro Kanai, null Ryunosuke Saiki, null Takayoshi Hyugaji, null Eigo Shimizu, null Kotoe Katayama, null Satoru Miyawaki, null Meiko Takahashi, null Fumihiko Matsuda, null Yosuke Omae, null Yasuhito Nannya, null Takafumi Ueno, null Yuko Kitagawa, null Katsushi Tokunaga, and null The Japan COVID‐19 Task Force

Published
2022

10. Blood Interleukin-6 Levels Predict Multiple Organ Dysfunction in Critically Ill Patients

Author

Takayuki Shibusawa, Takeshi Moriguchi, Kenichi Matsuda, Shigeto Oda, Taka-aki Nakada, Megumi Yazaki, Takashi Shimazui, Hiroki Otsubo, Yuto Teshima, Masakazu Nabeta, Toshihiko Mayumi, Junichi Sasaki, and Osamu Takasu

Subjects
Male, medicine.medical_specialty, Critical Illness, Multiple Organ Failure, Critical Care and Intensive Care Medicine, Gastroenterology, Procalcitonin, Predictive Value of Tests, Internal medicine, Intensive care, medicine, Humans, Prospective Studies, Aged, Aged, 80 and over, Receiver operating characteristic, Interleukin-6, business.industry, Organ dysfunction, Emergency department, Middle Aged, medicine.disease, Confidence interval, Systemic inflammatory response syndrome, Emergency Medicine, Biomarker (medicine), Female, medicine.symptom, business, Biomarkers
Abstract

Background Predicting multiple organ dysfunction (MOD) in the late phase of critical illnesses is essential. Cytokines are considered biomarkers that can predict clinical outcomes; however, their predictive value for late-phase MOD is unknown. This study aimed to identify the biomarker with the highest predictive value for late-phase MOD. Methods This observational study prospectively evaluated data on adult patients with systemic inflammatory response syndrome, those who presented to the emergency department or were admitted to intensive care units in five tertiary hospitals (n = 174). Seven blood biomarkers levels (interleukin-6 [IL-6], IL-8, IL-10, tumor-necrosis factor-α, white blood cells, C-reactive protein, and procalcitonin) were measured at three timepoints (day 0, 1, and 2). The area under the receiver operating characteristic curve (AUC) were analyzed to evaluate predictive values for MOD (primary outcome, MOD on day 7 [late-phase]; secondary outcome, MOD on day 3 [early-phase]). Results Of the measured 7 biomarkers, blood IL-6 levels on day 2 had the highest predictive value for MOD on day 7 using single timepoint data (AUC 0.825, 95% confidence interval [CI] 0.754-0.879). Using three timepoint biomarkers, blood IL-6 levels had the highest predictive value of MOD on day 7 (AUC 0.838, 95% CI 0.768-0.890). Blood IL-6 levels using three timepoint biomarkers had also the highest predictive value for MOD on day 3 (AUC 0.836, 95% CI 0.766-0.888). Conclusion Of the measured biomarkers, blood IL-6 levels had the highest predictive value for MOD on days 3 and 7. Blood IL-6 levels predict early- and late-phase MOD in critically ill patients.

Published
2020

11. Modified abbreviated burn severity index as a predictor of in-hospital mortality in patients with inhalation injury: development and validation using independent cohorts

Author

Takayuki Shibusawa, Ryo Yamamoto, Naoki Aikawa, and Junichi Sasaki

Subjects
Adult, Male, Prognostic variable, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Poison control, Logistic regression, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Injury prevention, medicine, Humans, Hospital Mortality, Aged, Retrospective Studies, Aged, 80 and over, Mechanical ventilation, Hyperbaric Oxygenation, Trauma Severity Indices, business.industry, General Medicine, Odds ratio, Middle Aged, Prognosis, Missing data, Respiration, Artificial, Research Design, 030220 oncology & carcinogenesis, Inhalation injury, Female, 030211 gastroenterology & hepatology, Surgery, business, Burns, Inhalation, Forecasting
Abstract

The ability to accurately evaluate the severity of inhalation injury can help to optimize patient care. However, there is no accepted severity grading system, especially for inhalation injury. We screened a multicenter burn registry and included adult patients who required oxygen treatment or mechanical ventilation. After the patient data were divided into development and validation cohorts, missing values were replaced with multiple imputation. Twelve potential predictors were analyzed using multivariate logistic regression to identify prognostic variables for in-hospital mortality and scores were assigned to each predictor based on odds ratios to develop the Modified Abbreviated Burn Severity Index, mABSI. The mABSI was validated using c-statistics and calibration curves. We randomly assigned 1377 and 919 patients to the development and validation cohorts, respectively. Age, self-inflicted injury, cutaneous burn area, and mechanical ventilation requirement were identified as independent predictors, and the mABSI (1–17 scale) was, thus, developed. The mABSI has a high discriminatory power (c-statistic = 0.94; 95% CI 0.92–0.97), and both estimated and observed in-hospital mortalities increased from 1% at score ≤ 5 to almost 100% at score ≥ 14 with linear calibration plots. We developed and validated the mABSI which accurately predicts in-hospital mortality.

Published
2020

12. The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

Author

Qingbo S. Wang, Ryuya Edahiro, Ho Namkoong, Takanori Hasegawa, Yuya Shirai, Kyuto Sonehara, Hiromu Tanaka, Ho Lee, Ryunosuke Saiki, Takayoshi Hyugaji, Eigo Shimizu, Kotoe Katayama, Masahiro Kanai, Tatsuhiko Naito, Noah Sasa, Kenichi Yamamoto, Yasuhiro Kato, Takayoshi Morita, Kazuhisa Takahashi, Norihiro Harada, Toshio Naito, Makoto Hiki, Yasushi Matsushita, Haruhi Takagi, Masako Ichikawa, Ai Nakamura, Sonoko Harada, Yuuki Sandhu, Hiroki Kabata, Katsunori Masaki, Hirofumi Kamata, Shinnosuke Ikemura, Shotaro Chubachi, Satoshi Okamori, Hideki Terai, Atsuho Morita, Takanori Asakura, Junichi Sasaki, Hiroshi Morisaki, Yoshifumi Uwamino, Kosaku Nanki, Sho Uchida, Shunsuke Uno, Tomoyasu Nishimura, Takashri Ishiguro, Taisuke Isono, Shun Shibata, Yuma Matsui, Chiaki Hosoda, Kenji Takano, Takashi Nishida, Yoichi Kobayashi, Yotaro Takaku, Noboru Takayanagi, Soichiro Ueda, Ai Tada, Masayoshi Miyawaki, Masaomi Yamamoto, Eriko Yoshida, Reina Hayashi, Tomoki Nagasaka, Sawako Arai, Yutaro Kaneko, Kana Sasaki, Etsuko Tagaya, Masatoshi Kawana, Ken Arimura, Kunihiko Takahashi, Tatsuhiko Anzai, Satoshi Ito, Akifumi Endo, Yuji Uchimura, Yasunari Miyazaki, Takayuki Honda, Tomoya Tateishi, Shuji Tohda, Naoya Ichimura, Kazunari Sonobe, Chihiro Tani Sassa, Jun Nakajima, Yasushi Nakano, Yukiko Nakajima, Ryusuke Anan, Ryosuke Arai, Yuko Kurihara, Yuko Harada, Kazumi Nishio, Tetsuya Ueda, Masanori Azuma, Ryuichi Saito, Toshikatsu Sado, Yoshimune Miyazaki, Ryuichi Sato, Yuki Haruta, Tadao Nagasaki, Yoshinori Yasui, Yoshinori Hasegawa, Yoshikazu Mutoh, Tomoki Kimura, Tomonori Sato, Reoto Takei, Satoshi Hagimoto, Yoichiro Noguchi, Yasuhiko Yamano, Hajime Sasano, Sho Ota, Yasushi Nakamori, Kazuhisa Yoshiya, Fukuki Saito, Tomoyuki Yoshihara, Daiki Wada, Hiromu Iwamura, Syuji Kanayama, Shuhei Maruyama, Takashi Yoshiyama, Ken Ohta, Hiroyuki Kokuto, Hideo Ogata, Yoshiaki Tanaka, Kenichi Arakawa, Masafumi Shimoda, Takeshi Osawa, Hiroki Tateno, Isano Hase, Shuichi Yoshida, Shoji Suzuki, Miki Kawada, Hirohisa Horinouchi, Fumitake Saito, Keiko Mitamura, Masao Hagihara, Junichi Ochi, Tomoyuki Uchida, Rie Baba, Daisuke Arai, Takayuki Ogura, Hidenori Takahashi, Shigehiro Hagiwara, Genta Nagao, Shunichiro Konishi, Ichiro Nakachi, Koji Murakami, Mitsuhiro Yamada, Hisatoshi Sugiura, Hirohito Sano, Shuichiro Matsumoto, Nozomu Kimura, Yoshinao Ono, Hiroaki Baba, Yusuke Suzuki, Sohei Nakayama, Keita Masuzawa, Shinichi Namba, Takayuki Shiroyama, Yoshimi Noda, Takayuki Niitsu, Yuichi Adachi, Takatoshi Enomoto, Saori Amiya, Reina Hara, Yuta Yamaguchi, Teruaki Murakami, Tomoki Kuge, Kinnosuke Matsumoto, Yuji Yamamoto, Makoto Yamamoto, Midori Yoneda, Kazunori Tomono, Kazuto Kato, Haruhiko Hirata, Yoshito Takeda, Hidefumi Koh, Tadashi Manabe, Yohei Funatsu, Fumimaro Ito, Takahiro Fukui, Keisuke Shinozuka, Sumiko Kohashi, Masatoshi Miyazaki, Tomohisa Shoko, Mitsuaki Kojima, Tomohiro Adachi, Motonao Ishikawa, Kenichiro Takahashi, Takashi Inoue, Toshiyuki Hirano, Keigo Kobayashi, Hatsuyo Takaoka, Kazuyoshi Watanabe, Naoki Miyazawa, Yasuhiro Kimura, Reiko Sado, Hideyasu Sugimoto, Akane Kamiya, Naota Kuwahara, Akiko Fujiwara, Tomohiro Matsunaga, Yoko Sato, Takenori Okada, Yoshihiro Hirai, Hidetoshi Kawashima, Atsuya Narita, Kazuki Niwa, Yoshiyuki Sekikawa, Koichi Nishi, Masaru Nishitsuji, Mayuko Tani, Junya Suzuki, Hiroki Nakatsumi, Takashi Ogura, Hideya Kitamura, Eri Hagiwara, Kota Murohashi, Hiroko Okabayashi, Takao Mochimaru, Shigenari Nukaga, Ryosuke Satomi, Yoshitaka Oyamada, Nobuaki Mori, Tomoya Baba, Yasutaka Fukui, Mitsuru Odate, Shuko Mashimo, Yasushi Makino, Kazuma Yagi, Mizuha Hashiguchi, Junko Kagyo, Tetsuya Shiomi, Satoshi Fuke, Hiroshi Saito, Tomoya Tsuchida, Shigeki Fujitani, Mumon Takita, Daiki Morikawa, Toru Yoshida, Takehiro Izumo, Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Mari Tone, Akihiro Ito, Yoshihiko Nakamura, Kota Hoshino, Junichi Maruyama, Hiroyasu Ishikura, Tohru Takata, Toshio Odani, Masaru Amishima, Takeshi Hattori, Yasuo Shichinohe, Takashi Kagaya, Toshiyuki Kita, Kazuhide Ohta, Satoru Sakagami, Kiyoshi Koshida, Kentaro Hayashi, Tetsuo Shimizu, Yutaka Kozu, Hisato Hiranuma, Yasuhiro Gon, Namiki Izumi, Kaoru Nagata, Ken Ueda, Reiko Taki, Satoko Hanada, Kodai Kawamura, Kazuya Ichikado, Kenta Nishiyama, Hiroyuki Muranaka, Kazunori Nakamura, Naozumi Hashimoto, Keiko Wakahara, Sakamoto Koji, Norihito Omote, Akira Ando, Nobuhiro Kodama, Yasunari Kaneyama, Shunsuke Maeda, Takashige Kuraki, Takemasa Matsumoto, Koutaro Yokote, Taka-Aki Nakada, Ryuzo Abe, Taku Oshima, Tadanaga Shimada, Masahiro Harada, Takeshi Takahashi, Hiroshi Ono, Toshihiro Sakurai, Takayuki Shibusawa, Yoshifumi Kimizuka, Akihiko Kawana, Tomoya Sano, Chie Watanabe, Ryohei Suematsu, Hisako Sageshima, Ayumi Yoshifuji, Kazuto Ito, Saeko Takahashi, Kota Ishioka, Morio Nakamura, Makoto Masuda, Aya Wakabayashi, Hiroki Watanabe, Suguru Ueda, Masanori Nishikawa, Yusuke Chihara, Mayumi Takeuchi, Keisuke Onoi, Jun Shinozuka, Atsushi Sueyoshi, Yoji Nagasaki, Masaki Okamoto, Sayoko Ishihara, Masatoshi Shimo, Yoshihisa Tokunaga, Yu Kusaka, Takehiko Ohba, Susumu Isogai, Aki Ogawa, Takuya Inoue, Satoru Fukuyama, Yoshihiro Eriguchi, Akiko Yonekawa, Keiko Kan-o, Koichiro Matsumoto, Kensuke Kanaoka, Shoichi Ihara, Kiyoshi Komuta, Yoshiaki Inoue, Shigeru Chiba, Kunihiro Yamagata, Yuji Hiramatsu, Hirayasu Kai, Koichiro Asano, Tsuyoshi Oguma, Yoko Ito, Satoru Hashimoto, Masaki Yamasaki, Yu Kasamatsu, Yuko Komase, Naoya Hida, Takahiro Tsuburai, Baku Oyama, Minoru Takada, Hidenori Kanda, Yuichiro Kitagawa, Tetsuya Fukuta, Takahito Miyake, Shozo Yoshida, Shinji Ogura, Shinji Abe, Yuta Kono, Yuki Togashi, Hiroyuki Takoi, Ryota Kikuchi, Shinichi Ogawa, Tomouki Ogata, Shoichiro Ishihara, Arihiko Kanehiro, Shinji Ozaki, Yasuko Fuchimoto, Sae Wada, Nobukazu Fujimoto, Kei Nishiyama, Mariko Terashima, Satoru Beppu, Kosuke Yoshida, Osamu Narumoto, Hideaki Nagai, Nobuharu Ooshima, Mitsuru Motegi, Akira Umeda, Kazuya Miyagawa, Hisato Shimada, Mayu Endo, Yoshiyuki Ohira, Masafumi Watanabe, Sumito Inoue, Akira Igarashi, Masamichi Sato, Hironori Sagara, Akihiko Tanaka, Shin Ohta, Tomoyuki Kimura, Yoko Shibata, Yoshinori Tanino, Takefumi Nikaido, Hiroyuki Minemura, Yuki Sato, Yuichiro Yamada, Takuya Hashino, Masato Shinoki, Hajime Iwagoe, Hiroshi Takahashi, Kazuhiko Fujii, Hiroto Kishi, Masayuki Kanai, Tomonori Imamura, Tatsuya Yamashita, Masakiyo Yatomi, Toshitaka Maeno, Shinichi Hayashi, Mai Takahashi, Mizuki Kuramochi, Isamu Kamimaki, Yoshiteru Tominaga, Tomoo Ishii, Mitsuyoshi Utsugi, Akihiro Ono, Toru Tanaka, Takeru Kashiwada, Kazue Fujita, Yoshinobu Saito, Masahiro Seike, Hiroko Watanabe, Hiroto Matsuse, Norio Kodaka, Chihiro Nakano, Takeshi Oshio, Takatomo Hirouchi, Shohei Makino, Moritoki Egi, Yosuke Omae, Yasuhito Nannya, Takafumi Ueno, Tomomi Takano, Kazuhiko Katayama, Masumi Ai, Atsushi Kumanogoh, Toshiro Sato, Naoki Hasegawa, Katsushi Tokunaga, Makoto Ishii, Ryuji Koike, Yuko Kitagawa, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga, and Yukinori Okada

Subjects
Multidisciplinary, Membrane Glycoproteins, Quantitative Trait Loci, General Physics and Astronomy, COVID-19, General Chemistry, Polymorphism, Single Nucleotide, General Biochemistry, Genetics and Molecular Biology, Japan, Viral infection, Humans, Lectins, C-Type, Gene expression, Receptors, Immunologic, Transcriptomics, Genome-Wide Association Study
Abstract

Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection., 「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.

Published
2021

13. The Japanese Society for Burn Injuries (JSBI) Clinical Practice Guidelines for Management of Burn Care (3rd Edition)

Author

Junichi Sasaki, Asako Matsushima, Hiroto Ikeda, Yoshiaki Inoue, Jiro Katahira, Miyuki Kishibe, Chu Kimura, Yukio Sato, Kiyotsugu Takuma, Katsumi Tanaka, Minoru Hayashi, Hajime Matsumura, Hiroshi Yasuda, Yuya Yoshimura, Hiromichi Aoki, Yoshihisa Ishizaki, Nobuo Isono, Takahiro Ueda, Kazuya Umezawa, Akinori Osuka, Takayuki Ogura, Yasuhiko Kaita, Katsuya Kawai, Kyoko Kawamoto, Masahiko Kimura, Takatsugu Kubo, Tomohiro Kurihara, Masato Kurokawa, Shuken Kobayashi, Daizoh Saitoh, Ryuji Shichinohe, Takayuki Shibusawa, Yuya Suzuki, Kazutaka Soejima, Ichiro Hashimoto, Osamu Fujiwara, Hiroshi Matsuura, Kazumasa Miida, Michiteru Miyazaki, Naoki Murao, Wataru Morikawa, and Sachiko Yamada

Subjects
General Engineering
Published
2021

14. Burn Injury Induces Intestinal Inflammatory Response Mediated by Th17 in Burn-Primed Endotoxemic Mice

Author

Takayuki Shibusawa, Kazuhiko Sekine, Seitaro Fujishima, Naoki Aikawa, and Junichi Sasaki

Subjects
0303 health sciences, Burn injury, Lactobacillus casei, biology, Mechanism (biology), business.industry, Inflammatory response, Lung injury, biology.organism_classification, 03 medical and health sciences, 0302 clinical medicine, Immunology, Medicine, Surgery, business, 030304 developmental biology, 030215 immunology
Abstract

Objective This study aimed to elucidate the mechanism underlying the susceptibility to infection-related acute lung injury by focusing on the role of gut mucosal T-helper (Th) 17 cells that preferentially produce IL-17 with probiotics in a burn-primed endotoxemic mice model. Methods Mice were subjected to a 15% total body surface area third-degree burn. Survival from lethal lipopolysaccharide (LPS) administration (3 mg/kg) on 11th day post-burn was assessed in mice fed by chow with or without 1.2% Lactobacillus powder after burn injury. Lamina propria mononuclear cells were enzymatically isolated from the ileum removed on 11th day post-burn and incubated along with 1 μg/mL LPS or 10 μg/mL anti-CD3 antibody for 24 hours; subsequently, the following 7 cytokines were analyzed in the supernatant: IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10, and IL-17. Results Lactobacillus treatment post-burn injury markedly improved survival after lethal endotoxemia in burn-primed mice (64.3% versus 21.4%, P = 0.03). The production of proinflammatory cytokines such as TNF-α, IL-6, and IL-17 by lamina propria mononuclear T-lymphocytes and macrophages including Th17 response was augmented by burn injury but decreased with Lactobacillus treatment after burn injury. Conclusions Th17- and Th17-mediated inflammatory responses in the gut mucosa may play a vital role, which could be attenuated by Lactobacillus treatment, in survival of lethal endotoxemia in burn-primed mice.

Published
2019

15. Self-inflicted Burn Injury Is Independently Associated With Increased Mortality in a More Economically Developed Country: A Propensity Score Matching Analysis

Author

Takayuki Shibusawa, Junichi Sasaki, Tomohiro Kurihara, and Ryo Yamamoto

Subjects
Adult, Male, medicine.medical_specialty, Burn injury, Adolescent, Logistic regression, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Japan, Humans, Medicine, Hospital Mortality, Propensity Score, Retrospective Studies, Abbreviated Injury Scale, business.industry, Rehabilitation, Hazard ratio, 030208 emergency & critical care medicine, Retrospective cohort study, Confidence interval, Suicide, Emergency medicine, Propensity score matching, Emergency Medicine, Female, Surgery, Burns, business, Self-Injurious Behavior, Total body surface area
Abstract

Self-inflicted burn accounts for considerable morbidity and mortality in more economically developed countries, and there is a substantial debate regarding the pathophysiological relevance between self-inflicted burns and unfavorable outcomes. To validate whether self-inflicted injury is an independent predictor of high mortality regardless of the severity of burn, they conducted a retrospective observational study using the Japan Trauma Data Bank, a nationwide database including over 200 major tertiary care centers. Among 2006 patients with burn who had arrived at collaborating centers between 2004 and 2016, they included patients aged ≥15 years, those who did not present with cardiopulmonary arrest upon arrival, and those who had ≥10 percent total body surface area burns. Patients with missing survival data or unknown mechanism of injury were excluded. In total, 1094 patients were eligible, of whom 222 (20.3 percent) had self-inflicted burns. The patients were divided into the self-inflicted and non-self-inflicted groups, and propensity score was calculated using the demographic information of the patients, injury variables, time from injury to hospital arrival, and other survival predictors. Via a propensity score matching, 98 pairs were selected, and the self-inflicted group had a higher mortality than the non-self-inflicted group (43.9 vs 28.6 percent, hazard ratio = 1.77; 95% confidence interval = 1.10-2.86; P = .02). Inverse probability weighting and multivariate logistic regression were performed as sensitivity analyses, and results validated that self-inflicted burn was independently associated with increased in-hospital mortality. Therefore, patients with self-inflicted burns should receive judicious management, regardless of burn injury severity.

Published
2019

16. Japan COVID-19 Task Force: a nation-wide consortium to elucidate host genetics of COVID-19 pandemic in Japan

Author

Shuichi Yoshida, Yoshihiro Hirai, Hiroshi Takahashi, Yoshiyuki Sekikawa, Saeko Takahashi, Yoshitaka Oyamada, Shunsuke Uno, Koutaro Yokote, Kunihiko Takahashi, Shigenari Nukaga, Yoshinao Ono, Shoichiro Ishihara, Nozomu Kimura, Tomohiro Adachi, Shigeki Fujitani, Eri Hagiwara, Motoyuki Suzuki, Tomouki Ogata, Namiki Izumi, Shinji Abe, Etsuko Tagaya, Yoshinori Hasegawa, Yoshimune Miyazaki, Junichi Sasaki, Yoshinori Tanino, Seishi Ogawa, Yuki Togashi, Satoshi Fuke, Yoshiaki Inoue, Hideo Ogata, Masaomi Yamamoto, Hiroshi Saito, Jun Shinozuka, Sho Uchida, Masayoshi Miyawaki, Atsushi Kumanogoh, Koichiro Matsumoto, Yuko Kitagawa, Mayu Endo, Mitsuru Odate, Hiroki Tateno, Fumitake Saito, Mizuki Kuramochi, Shoji Suzuki, Koji Murakami, Kenichi Arakawa, Shozo Yoshida, Hitoshi Sasano, Keigo Kobayashi, Takuro Nii, Takashi Ishiguro, Ryuichi Saito, Yohei Mikami, Takashi Inoue, Haruhiko Kishima, Daisuke Arai, Takao Mochimaru, Minoru Takada, Yuya Ueno, Takehiro Izumo, Reina Hara, Nobuyuki Hizawa, Atsuho Morita, Takanori Hasegawa, Masahiro Seike, Hisako Sageshima, Takeshi Hattori, Shinichi Namba, Shuko Mashimo, Tomoya Tsuchida, Hiromu Tanaka, Naoki Miyazawa, Masatoshi Kawana, Shunichiro Konishi, Takatoshi Enomoto, Takuya Hashino, Hiroki Watanabe, Kentaro Hayashi, Sumito Inoue, Satoshi Hagimoto, Toru Yoshida, Akiko Fujiwara, Masaki Okamoto, Hiroki Kabata, Shuji Tohda, Baku Oyama, Norihiko Takemoto, Nobuyasu Awano, Makoto Hiki, Yasutaka Fukui, Takahiro Fukui, Keisuke Onoi, Yuichiro Yamada, Takayuki Shiroyama, Mayuko Tani, Hiroyuki Muranaka, Kazuhide Ohta, Yoshifumi Kimizuka, Hajime Iwagoe, Yasuko Fuchimo, Hiroki Nakatsumi, Hiroyuki Minemura, Hisatoshi Sugiura, Haruhi Takagi, Hiroyuki Kokuto, Yasuhiro Kimura, Masatoshi Takagaki, Yuki Sato, Masao Hagihara, Junko Kagyo, Yusuke Kawamura, Sayoko Ishihara, Akinori Kimura, Aki Ogawa, Hironori Sagara, Noa Sasa, Masahiro Kanai, Isano Hase, Takenori Okada, Akiyoshi Nakayama, Osamu Narumoto, Norihito Omote, Kazunori Tomono, Toshiro Sato, Hatsuyo Takaoka, Mayumi Takeuchi, Keiko Kan-o, Satoshi Okamori, Yukinori Okada, Yoshito Takeda, Kazuto Ito, Tatsuhiko Naito, Reina Hayashi, Toshikatsu Sado, Kazuya Ichikado, Yasushi Matsushita, Nobuaki Mori, Takashi Nishida, Toshitaka Maeno, Tomomi Takano, Soichiro Ueda, Tomoyasu Nishimura, Masaru Nishitsuji, Ryusuke Anan, Arihiko Kanehiro, Akira Umeda, Syuji Kanayama, Yosuke Omae, Tomoki Nagasaka, Koichi Nishi, Yoshiyuki Ohira, Fumimaro Ito, Toru Tanaka, Kenichiro Takahashi, Hidenori Kanda, Hidenori Inohara, Kaoru Nagata, Kei Nishiyama, Masafumi Watanabe, Katsunori Masaki, Ryuzo Abe, Hirofumi Kamata, Masahiro Harada, Chihiro Tani Sassa, Tomoya Sano, Shoichi Ihara, Tadashi Manabe, Takafumi Ueno, Takahito Fukusumi, Meiko Takahashi, Kyuto Sonehara, Kana Sasaki, Hiroyuki Takoi, Chie Watanabe, Takahiro Tsuburai, Tomonori Sato, Yoichi Kobayashi, Kazuhisa Takahashi, Yasushi Nakano, Kenichi Yamamoto, Takayoshi Hyugaji, Hirohito Sano, Ho Namkoong, Atsushi Sueyoshi, Naoya Ichimura, Yoshiteru Tominaga, Masaru Amishima, Ken Suzuki, Ken Ohta, Shigehiro Hagiwara, Masayuki Kanai, Kota Hoshino, Shuhei Kawabata, Mitsuhiro Yamada, Toshio Naito, Akihiro Ono, Yotaro Takaku, Yoko Sato, Satoru Miyano, Junichi Ochi, Yoshikazu Mutoh, Hiroaki Baba, Yoko Shibata, Tatsuya Yamashita, Yoko Ito, Hiromu Iwamura, Munehisa Fukushima, Saori Amiya, Takayuki Honda, Yuta Kono, Susumu Isogai, Ryuya Edahiro, Makoto Masuda, Hisato Shimada, Hideaki Nagai, Tomoya Baba, Fukuki Saito, Toshihiro Sakurai, Ryota Kikuchi, Yoichiro Noguchi, Tatsuhiko Anzai, Mizuha Hashiguchi, Masamichi Sato, Naoki Hasegawa, Yasunari Miyazaki, Tetsuya Ueda, Yasuhiko Yamano, Shinji Ozaki, Yoshinobu Saito, Takuya Inoue, Sohei Nakayama, Sawako Arai, Yu Kusaka, Miki Kawada, Yuko Kurihara, Daiki Wada, Isamu Kamimaki, Motonao Ishikawa, Sumiko Kohashi, Sae Wada, Kazuma Yagi, Rino Ishihara, Hiroko Okabayashi, Nobuhiro Kodama, Mai Takahashi, Kiyoshi Komuta, Yusuke Chihara, Yoshihiko Nakamura, Akifumi Endo, Shuichiro Matsumoto, Akira Igarashi, Shuhei Yamada, Akiko Yonekawa, Yukiko Nakajima, Sakamoto Koji, Kazue Fujita, Masakiyo Yatomi, Makoto Ishii, Ryuji Koike, Eigo Shimizu, Shigeru Chiba, Satoru Miyawaki, Shunsuke Maeda, Toshio Odani, Hideyasu Sugimoto, Masanori Nishikawa, Yoshinori Yasui, Akira Ando, Takayuki Shibusawa, Nobuharu Ooshima, Toshiyuki Kita, Satoru Fukuyama, Ai Tada, Mariko Terashima, Tadao Nagasaki, Rie Baba, Atsuya Narita, Takanori Ogawa, Tetsuo Shimizu, Ken Ueda, Yuki Haruta, Satoru Hashimoto, Ryohei Suematsu, Ho Lee, Ryosuke Satomi, Hirotaka Eguchi, Kota Ishioka, Ryousuke Aoki, Yusuke Suzuki, Takemasa Matsumoto, Kazunari Sonobe, Hisato Hiranuma, Hirayasu Kai, Kosuke Yoshida, Ayumi Yoshifuji, Takeru Kashiwada, Yuko Harada, Reoto Takei, Aya Wakabayashi, Tomohiro Matsunaga, Haruhiko Hirata, Hiroshi Morisaki, Yoshifumi Uwamino, Yoshihisa Tokunaga, Kazuki Niwa, Hidetoshi Kawashima, Hideki Terai, Kenji Takano, Mumon Takita, Yuko Komase, Masaki Yamasaki, Chiaki Hosoda, Takayuki Ogura, Shun Shibata, Mitsuru Motegi, Takeshi Takahashi, Takehiko Ohba, Shinichi Hayashi, Satoshi Ito, Yu Kasamatsu, Shinnosuke Ikemura, Tetsuya Fukuta, Koichiro Asano, Taka-aki Nakada, Kota Murohashi, Tomoyuki Uchida, Hirotaka Matsuo, Satoko Hanada, Kenta Nishiyama, Minoru Inomata, Nobukazu Fujimoto, Tomoya Tateishi, Mitsuaki Kojima, Kazuto Kato, Kazuhiko Katayama, Yuichi Maeda, Takashi Kagaya, Keiko Wakahara, Takashi Ogura, Yasuhiro Gon, Taku Oshima, Ken Arimura, Shuhei Maruyama, Mari Tone, Ryuichi Sato, Koichi Fukunaga, Hidefumi Koh, Yuichiro Kitagawa, Noboru Takayanagi, Masatoshi Miyazaki, Ichiro Nakachi, Akihiko Kawana, Toshiyuki Hirano, Yohei Funatsu, Yasushi Nakamori, Reiko Sado, Yasuo Shichinohe, Junya Suzuki, Yasunari Kaneyama, Takahito Miyake, Kunihiro Yamagata, Yasuhito Nannya, Shinichi Ogawa, Naoya Hida, Tsuyoshi Oguma, Kazunori Nakamura, Kosaku Nanki, Naozumi Hashimoto, Fumihiko Matsuda, Tomoyuki Kimura, Daiki Morikawa, Yuji Uchimura, Yoshiaki Tanaka, Kazuhisa Yoshiya, Takashige Kuraki, Yoshihiro Eriguchi, Tomohisa Shoko, Tadanaga Shimada, Yuji Hiramatsu, Akihiko Tanaka, Hideya Kitamura, Yutaka Kozu, Ryosuke Arai, Taisuke Isono, Yasushi Makino, Seiya Imoto, Yuichi Adachi, Yuma Matsui, Masato Shinoki, Kazumi Nishio, Keiko Mitamura, Tomonori Imamura, Masanori Azuma, Sonoko Harada, Hiroshi Ono, Kotoe Katayama, Masumi Ai, Keisuke Shinozuka, Reiko Taki, Junichi Maruyama, Takao Imai, Yutaro Kaneko, Kensuke Kanaoka, Sho Ota, Yoji Nagasaki, Toshihiro Kishikawa, Takayuki Niitsu, Hirohisa Horinouchi, Naoyuki Kuse, Tetsuya Shiomi, Jun Nakajima, Katsushi Tokunaga, Norihiro Harada, Keita Masuzawa, Noriyuki Kijima, Takeshi Osawa, Satoru Sakagami, Kazuhiko Fujii, Shotaro Chubachi, Tomoyuki Yoshihara, Yoshimi Noda, Hiroyasu Ishikura, Kiyoshi Koshida, Shin Ohta, Ai Nakamura, Naota Kuwahara, Shinji Ogura, Suguru Ueda, Akihiro Ito, Morio Nakamura, Tohru Takata, Yuya Shirai, Hidenori Takahashi, Eriko Yoshida, Satoru Beppu, Mitsuyoshi Utsugi, Masafumi Shimoda, Masatoshi Shimo, Tomoo Ishii, Takefumi Nikaido, Takanori Asakura, Kazuya Miyagawa, Takanori Kanai, Hiroto Kishi, Akane Kamiya, Genta Nagao, Kodai Kawamura, Ryunosuke Saiki, Takashi Yoshiyama, Hajime Sasano, Kazuyoshi Watanabe, and Yuta Matsubara

Subjects
Genetics, education.field_of_study, Population, Mendelian Randomization Analysis, Genome-wide association study, Odds ratio, Biology, medicine.disease, Obesity, Confidence interval, Minor allele frequency, Pandemic, medicine, education
Abstract

To elucidate the host genetic loci affecting severity of SARS-CoV-2 infection, or Coronavirus disease 2019 (COVID-19), is an emerging issue in the face of the current devastating pandemic. Here, we report a genome-wide association study (GWAS) of COVID-19 in a Japanese population led by the Japan COVID-19 Task Force, as one of the initial discovery GWAS studies performed on a non-European population. Enrolling a total of 2,393 cases and 3,289 controls, we not only replicated previously reported COVID-19 risk variants (e.g., LZTFL1, FOXP4, ABO, and IFNAR2), but also found a variant on 5p35 (rs60200309-A at DOCK2) that was significantly associated with severe COVID-19 in younger (-8 (odds ratio = 2.01, 95% confidence interval = 1.58-2.55). This risk allele was prevalent in East Asians, including Japanese (minor allele frequency [MAF] = 0.097), but rarely found in Europeans. Cross-population Mendelian randomization analysis made a causal inference of a number of complex human traits on COVID-19. In particular, obesity had a significant impact on severe COVID-19. The presence of the population-specific risk allele underscores the need of non-European studies of COVID-19 host genetics.

Published
2021

17. Diagnostic Accuracy of Biomarkers for Early Multiple Organ Dysfunction in Critically Ill Patients: A Multicenter Prospective Observational Study

Author

Shigeto Ishikawa, Yuto Teshima, Hiroki Otsubo, Takashi Shimazui, Taka-aki Nakada, Osamu Takasu, Kenichi Matsuda, Junichi Sasaki, Masakazu Nabeta, Takeshi Moriguchi, Takayuki Shibusawa, Toshihiko Mayumi, and Shigeto Oda

Abstract

BackgroundShock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA).MethodsThis observational study was conducted at five universities from 2016 to 2018. Data of adult patients with systemic inflammatory response syndrome who presented to the emergency department or were admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10, tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The primary outcome was set as MOD on Day 2, and the area under the receiver operating characteristic curve (AUROC) was analyzed to evaluate qSOFA scores and biomarker levels.ResultsOf 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse prognosis, including mortality. The AUROC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95% confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI: 0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.859 [95% CI: 0.792–0.907]). The combination model using qSOFA (Day 0) and IL-6 (Day 1) also showed a higher AUROC (0.889 [95% CI: 0.828–0.929]).ConclusionsThe addition of serum IL-6 level to qSOFA scores improved the accuracy of early MOD prediction.

Published
2020

18. Accuracy for mortality prediction with additive biomarkers including interleukin-6 in critically ill patients: a multicenter prospective observational study

Author

Takashi Shimazui, Kenichi Matsuda, Shigeto Oda, Junichi Sasaki, Masakazu Nabeta, Takayuki Shibusawa, Osamu Takasu, Takeshi Moriguchi, Taka-aki Nakada, Toshihiko Mayumi, Yuto Teshima, Ryo Yamamoto, and Hiroki Otsubo

Subjects
medicine.medical_specialty, critically ill, Observational Study, Logistic regression, Procalcitonin, Sequential Organ Failure Assessment, Internal medicine, Medicine, Interleukin 6, Univariate analysis, biology, Receiver operating characteristic, RC86-88.9, business.industry, interleukin, Medical emergencies. Critical care. Intensive care. First aid, General Medicine, prediction, medicine.disease, mortality, Systemic inflammatory response syndrome, biology.protein, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Biomarker (medicine), Observational study, business
Abstract

Supplemental Digital Content is available in the text., Objectives: Several inflammation markers have been reported to be associated with unfavorable clinical outcomes in critically ill patients. We aimed to elucidate whether serum interleukin-6 concentration considered with Sequential Organ Failure Assessment score can better predict mortality in critically ill patients. Design: A prospective observational study. Setting: Five university hospitals in 2016–2018. Patients: Critically ill adult patients who met greater than or equal to two systemic inflammatory response syndrome criteria at admission were included, and those who died or were discharged within 48 hours were excluded. Interventions: Inflammatory biomarkers including interleukin (interleukin)–6, -8, and -10; tumor necrosis factor–α; C-reactive protein; and procalcitonin were blindly measured daily for 3 days. Area under the receiver operating characteristic curve for Sequential Organ Failure Assessment score at day 2 according to 28-day mortality was calculated as baseline. Combination models of Sequential Organ Failure Assessment score and additional biomarkers were developed using logistic regression, and area under the receiver operating characteristic curve calculated in each model was compared with the baseline. Measurements and Main Results: Among 161 patients included in the study, 18 (11.2%) did not survive at day 28. Univariate analysis for each biomarker identified that the interleukin-6 (days 1–3), interleukin-8 (days 0–3), and interleukin-10 (days 1–3) were higher in nonsurvivors than in survivors. Analyses of 28-day mortality prediction by a single biomarker showed interleukin-6, -8, and -10 at days 1–3 had a significant discrimination power, and the interleukin-6 at day 3 had the highest area under the receiver operating characteristic curve (0.766 [0.656–0.876]). The baseline area under the receiver operating characteristic curve for Sequential Organ Failure Assessment score predicting 28-day mortality was 0.776 (0.672–0.880). The combination model using additional interleukin-6 at day 3 had higher area under the receiver operating characteristic curve than baseline (area under the receiver operating characteristic curve = 0.844, area under the receiver operating characteristic curve improvement = 0.068 [0.002–0.133]), whereas other biomarkers did not improve accuracy in predicting 28-day mortality. Conclusions: Accuracy for 28-day mortality prediction was improved by adding serum interleukin-6 concentration to Sequential Organ Failure Assessment score.

Published
2020

19. 経皮的心肺補助装置が有用だった偶発性低体温症による心肺停止の1例(A case of cardiopulmonary arrest due to accidental hypothermia that was treated effectively with extracorporeal membrane oxygenation)

Author

(Toshihiro Sakurai), 櫻井 聖大, primary, (Shu Yamada), 山田 周, additional, (Takayuki Shibusawa), 渋沢 崇行, additional, (Chikako Shimizu), 清水 千華子, additional, (Maki Kitada), 北田 真己, additional, (Masahiro Harada), 原田 正公, additional, and (Takeshi Takahashi), 高橋 毅, additional

Published
2021
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20. Hydrogen gas inhalation alleviates oxidative stress in patients with post-cardiac arrest syndrome

Author

Shingo Hori, Yosuke Kobayashi, Joe Yoshizawa, Masaru Suzuki, Takayuki Shibusawa, Kei Hayashida, Motoaki Sano, Tomoyoshi Tamura, and Junichi Sasaki

Subjects
Nutrition and Dietetics, Inhalation, business.industry, medicine.medical_treatment, Clinical Biochemistry, Medicine (miscellaneous), chemistry.chemical_element, Urine, Pharmacology, medicine.disease_cause, Oxygen, molecular hydrogen gas, Pathophysiology, chemistry.chemical_compound, Cytokine, chemistry, anti-inflammatory effect, Deoxyguanosine, Medicine, anti-oxidative effect, target temperature management, Tumor necrosis factor alpha, Original Article, business, Oxidative stress
Abstract

Oxidative stress plays a key role in the pathophysiology of post-cardiac arrest syndrome. Molecular hydrogen reduces oxidative stress and exerts anti-inflammatory effects in an animal model of cardiac arrest. However, its effect on human post-cardiac arrest syndrome is unclear. We consecutively enrolled five comatose post-cardiac arrest patients (three males; mean age, 65 ± 15 years; four cardiogenic, one septic cardiac arrest) and evaluated temporal changes in oxidative stress markers and cytokines with inhaled hydrogen. All patients were treated with target temperature management. Hydrogen gas inhalation (2% hydrogen with titrated oxygen) was initiated upon admission for 18 h. Blood hydrogen concentrations, plasma and urine oxidative stress markers (derivatives of reactive oxygen metabolites, biological antioxidant potential, 8-hydroxy-2'-deoxyguanosine, N ɛ-hexanoyl-lysine, lipid hydroperoxide), and cytokines (interleukin-6 and tumor necrosis factor-α) were measured before and 3, 9, 18, and 24 h after hydrogen gas inhalation. Arterial hydrogen concentration was measurable and it was equilibrated with inhaled hydrogen. Oxidative stress was reduced and cytokine levels were unchanged in cardiogenic patients, whereas oxidative stress was unchanged and cytokine levels were diminished in the septic patient. The effect of inhaled hydrogen on oxidative stress and cytokines in comatose post-cardiac arrest patients remains indefinite because of methodological weaknesses.

Published
2019

21. Development of Novel Criteria of the 'Lethal Triad' as an Indicator of Decision Making in Current Trauma Care

Author

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

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Clinical Decision-Making, MEDLINE, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Body Temperature, 03 medical and health sciences, Triad (sociology), Injury Severity Score, 0302 clinical medicine, Japan, Predictive Value of Tests, Outcome Assessment, Health Care, Health care, Humans, Medicine, Child, Intensive care medicine, Aged, Retrospective Studies, Blood coagulation test, business.industry, 030208 emergency & critical care medicine, Retrospective cohort study, Middle Aged, Prognosis, Child, Preschool, Predictive value of tests, Wounds and Injuries, Female, Observational study, Blood Coagulation Tests, business
Abstract

To evaluate the utility of the conventional lethal triad in current trauma care practice and to develop novel criteria as indicators of treatment strategy.Retrospective observational study.Fifteen acute critical care medical centers in Japan.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.None.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 µg/mL 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%.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.

Published
2016

22. High D-Dimer Levels Predict a Poor Outcome in Patients with Severe Trauma, Even with High Fibrinogen Levels on Arrival

Author

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

Subjects
Adult, Male, medicine.medical_specialty, Critical Care and Intensive Care Medicine, Fibrinogen, Gastroenterology, Disease-Free Survival, coagulopathy, Fibrin Fibrinogen Degradation Products, Mice, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, D-dimer, medicine, Coagulopathy, Animals, Humans, 030212 general & internal medicine, Survival rate, disseminated intravascular coagulation, transfusion, Aged, Retrospective Studies, Disseminated intravascular coagulation, Trauma Severity Indices, business.industry, 030208 emergency & critical care medicine, Retrospective cohort study, Middle Aged, medicine.disease, Hyperfibrinolysis, Survival Rate, Immunology, Emergency Medicine, Wounds and Injuries, Injury Severity Score, fibrinolysis, multiple trauma, Erythrocyte Transfusion, business, medicine.drug
Abstract

Elevated D-dimer level in trauma patients is associated with tissue damage severity and is an indicator of hyperfibrinolysis during the early phase of trauma. To investigate the interacting effects of fibrinogen and D-dimer levels on arrival at the emergency department for massive transfusion and mortality in severe trauma patients in a multicentre retrospective study. This study included 519 adult trauma patients with an injury severity score ≥16. Patients with ≥10 units of red cell concentrate transfusion and/or death during the first 24 hours were classified as having a poor outcome. Receiver operating characteristic curve analysis for predicting poor outcome showed the optimal cut-off fibrinogen and D-dimer values to be 190 mg/dL and 38 mg/L, respectively. Based on these values, patients were divided into four groups: (1) low D-dimer (190 mg/dL), (2) low D-dimer (190 mg/dL), and (4) high D-dimer (≥38 mg/L)/low fibrinogen (≤190 mg/dL). The survival rate was lower in the high D-dimer/low fibrinogen group than in the other groups. Moreover, the survival rate was lower in the high D-dimer/high fibrinogen group than in the low D-dimer/high fibrinogen and low D-dimer/low fibrinogen groups. High D-dimer level on arrival is a strong predictor of early death or requirement for massive transfusion in severe trauma patients, even with high fibrinogen levels.

Published
2016

23. Feasibility and Safety of Hydrogen Gas Inhalation for Post-Cardiac Arrest Syndrome – First-in-Human Pilot Study –

Author

Yosuke Kobayashi, Joe Yoshizawa, Masaru Suzuki, Shigeo Ohta, Motoaki Sano, Keiichi Fukuda, Takeshi Suzuki, Hiroshi Morisaki, Kei Hayashida, Takayuki Shibusawa, Tomoyoshi Tamura, and Shingo Hori

Subjects
Male, 0301 basic medicine, Pilot Projects, 030204 cardiovascular system & hematology, Return of spontaneous circulation, Cardiac dysfunction, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Prospective Studies, Post cardiac arrest, Prospective cohort study, Aged, Inhalation, business.industry, Hydrogen molecule, General Medicine, First in human, Middle Aged, Heart Arrest, Clinical trial, 030104 developmental biology, Anesthesia, Female, Cardiology and Cardiovascular Medicine, business, Hydrogen
Abstract

Background Hydrogen gas inhalation (HI) ameliorates cerebral and cardiac dysfunction in animal models of post-cardiac arrest syndrome (PCAS). HI for human patients with PCAS has never been studied. Methods and results Between January 2014 and January 2015, 21 of 107 patients with out-of-hospital cardiac arrest achieved spontaneous return of circulation. After excluding 16 patients with specific criteria, 5 patients underwent HI together with target temperature management (TTM). No undesirable effects attributable to HI were observed and 4 patients survived 90 days with a favorable neurological outcome. Conclusions HI in combination with TTM is a feasible therapy for patients with PCAS. (Circ J 2016; 80: 1870-1873).

Published
2016

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

Author

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

Subjects
Male, Pelvic brim, medicine.medical_specialty, Rotation, Hemorrhage, Abdominal cavity, 030230 surgery, Fractures, Bone, 03 medical and health sciences, 0302 clinical medicine, Fracture Fixation, Fracture fixation, Cadaver, Pressure, medicine, Humans, Orthopedics and Sports Medicine, Pelvic Bones, Pelvis, Aged, Aged, 80 and over, Pelvic floor, Hemostatic Techniques, business.industry, Abdominal Cavity, 030208 emergency & critical care medicine, Pelvic cavity, medicine.disease, Bandages, Embolization, Therapeutic, Surgery, body regions, medicine.anatomical_structure, Pelvic fracture, business, Venous return curve
Abstract

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. [ Orthopedics. 2017; 40(6);e947–e951.]

Published
2017

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

Author

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

Subjects
Adult, Male, medicine.medical_specialty, Critical Care, Vital signs, Blood Pressure, Hemorrhage, 030204 cardiovascular system & hematology, Wounds, Nonpenetrating, 03 medical and health sciences, 0302 clinical medicine, Injury Severity Score, Patient Admission, Japan, Predictive Value of Tests, Internal medicine, medicine, Humans, Blood Transfusion, General Environmental Science, Aged, Retrospective Studies, Receiver operating characteristic, business.industry, Glasgow Coma Scale, Fibrinogen, 030208 emergency & critical care medicine, Odds ratio, Middle Aged, Confidence interval, Surgery, Blood pressure, Logistic Models, Blunt trauma, General Earth and Planetary Sciences, Female, Packed red blood cells, business, Biomarkers
Abstract

Introduction In the early phase of trauma, fibrinogen (Fbg) plays an important role in clot formation. However, to the best of our knowledge, few studies have analysed methods of predicting the need for massive transfusion (MT) based on Fbg levels using multiple logistic regression. Therefore, the present study aimed to evaluate whether Fbg levels on admission can be used to predict the need for MT in patients with trauma. Methods We conducted a retrospective multicentre observational study. Patients with blunt trauma with ISS ≥16 who were admitted to 15 tertiary emergency and critical care centres in Japan participating in the J-OCTET were enrolled in the present study. MT was defined as the transfusion of packed red blood cells (PRBC) ≥10 units or death caused by bleeding within 24 h after admission. Patients were divided into non-MT and MT groups. Multiple logistic-regression analysis was used to assess the predictive value of the variables age, sex, vital signs, Glasgow Coma Scale (GCS) score, and Fbg levels for MT. We also evaluated the discrimination threshold of MT prediction via receiver operating characteristic curve (ROC) analysis for each variable. Results Higher heart rate (HR; per 10 beats per minutes [bpm]), systolic blood pressure (SBP; per 10 mm Hg), GCS, and Fbg levels (per 10 mg/dL) were independent predictors of MT (odds ratio [OR] 1.480, 95% confidence interval [CI] 1.326–1.668; OR 0.851, 95% CI 0.789–0.914; OR 0.907, 95% CI 0.855–0.962; and OR 0.931, 95% CI 0.898–0.963, respectively). The optimal cut-off values for HR, SBP, GCS, and Fbg levels were ≥100 bpm (sensitivity 62.4%, specificity 79.8%), ≤120 mm Hg (sensitivity 61.5%, specificity 70.5%), ≤12 points (sensitivity 63.3%, specificity 63.6%), and ≤190 mg/dL (sensitivity 55.1%, specificity 78.6%), respectively. Conclusions Our findings suggest that vital signs, GCS, and decreased Fbg levels can be regarded as predictors of MT. Therefore, future studies should consider Fbg levels when devising models for the prediction of MT.

Published
2016

29. Self-inflicted Burn Injury Is Independently Associated With Increased Mortality in a More Economically Developed Country: A Propensity Score Matching Analysis.

Author

Ryo Yamamoto, Takayuki Shibusawa, Tomohiro Kurihara, and Junichi Sasaki

Subjects
PROPENSITY score matching, DEVELOPED countries, HOSPITAL mortality, BODY surface area, CARDIAC arrest
Abstract

Self-inflicted burn accounts for considerable morbidity and mortality in more economically developed countries, and there is a substantial debate regarding the pathophysiological relevance between self-inflicted burns and unfavorable outcomes. To validate whether self-inflicted injury is an independent predictor of high mortality regardless of the severity of burn, they conducted a retrospective observational study using the Japan Trauma Data Bank, a nationwide database including over 200 major tertiary care centers. Among 2006 patients with burn who had arrived at collaborating centers between 2004 and 2016, they included patients aged ≥15 years, those who did not present with cardiopulmonary arrest upon arrival, and those who had ≥10 percent total body surface area burns. Patients with missing survival data or unknown mechanism of injury were excluded. In total, 1094 patients were eligible, of whom 222 (20.3 percent) had self-inflicted burns. The patients were divided into the self-inflicted and non-self-inflicted groups, and propensity score was calculated using the demographic information of the patients, injury variables, time from injury to hospital arrival, and other survival predictors. Via a propensity score matching, 98 pairs were selected, and the self-inflicted group had a higher mortality than the non-self-inflicted group (43.9 vs 28.6 percent, hazard ratio = 1.77; 95% confidence interval = 1.10-2.86; P = .02). Inverse probability weighting and multivariate logistic regression were performed as sensitivity analyses, and results validated that self-inflicted burn was independently associated with increased in-hospital mortality. Therefore, patients with self-inflicted burns should receive judicious management, regardless of burn injury severity. [ABSTRACT FROM AUTHOR]

Published
2019
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30. Hyperfibrinolysis in severe isolated traumatic brain injury may occur without tissue hypoperfusion : a retrospective observational multicentre study

Author

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

Subjects
Adult, Male, medicine.medical_specialty, Traumatic brain injury, 030204 cardiovascular system & hematology, Disseminated intravascular coagulation, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Injury Severity Score, Japan, Trauma Centers, Coagulopathy, Brain Injuries, Traumatic, medicine, Humans, Fibrinogen degradation product, Blood coagulation test, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Research, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Hyperfibrinolysis, Surgery, nervous system diseases, Hypoperfusion, Thromboelastometry, nervous system, Anesthesia, Female, Blood Coagulation Tests, business, Partial thromboplastin time
Abstract

Background Hyperfibrinolysis is a critical complication in severe trauma. Hyperfibrinolysis is traditionally diagnosed via elevated D-dimer or fibrin/fibrinogen degradation product levels, and recently, using thromboelastometry. Although hyperfibrinolysis is observed in patients with severe isolated traumatic brain injury (TBI) on arrival at the emergency department (ED), it is unclear which factors induce hyperfibrinolysis. The present study aimed to investigate the factors associated with hyperfibrinolysis in patients with isolated severe TBI. Methods We conducted a multicentre retrospective review of data for adult trauma patients with an injury severity score ≥ 16, and selected patients with isolated TBI (TBI group) and extra-cranial trauma (non-TBI group). The TBI group included patients with an abbreviated injury score (AIS) for the head ≥ 4 and an extra-cranial AIS

Published
2017

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

Author

YUKIO SATO, KAZUHIKO SEKINE, TAKAYUKI SHIBUSAWA, KOSUKE TAJIMA, JUNICHI SASAKI, NOBUAKI IMANISHI, SADAKAZU AISO, SHINGO HORI, Sato, Yukio, Sekine, Kazuhiko, Shibusawa, Takayuki, Tajima, Kosuke, Sasaki, Junichi, Imanishi, Nobuaki, Aiso, Sadakazu, and Hori, Shingo

Abstract

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. [Orthopedics. 2017; 40(6);e947-e951.]. [ABSTRACT FROM AUTHOR]

Published
2017
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32. Hyperfibrinolysis in severe isolated traumatic brain injury may occur without tissue hypoperfusion: a retrospective observational multicentre study.

Author

Mineji Hayakawa, Kunihiko Maekawa, Shigeki Kushimoto, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogur, Tetsuya Matsuoka, Toshifumi Uejima, Naoto Morimura, Hiroyasu Ishikura, Akiyoshi Hagiwara, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Daisuke Kudo, Takashi Kanemura, Takayuki Shibusawa, Shintaro Furugori, Yoshihiko Nakamura, and Atsushi Shiraishi

Abstract

Background: Hyperfibrinolysis is a critical complication in severe trauma. Hyperfibrinolysis is traditionally diagnosed via elevated D-dimer or fibrin/fibrinogen degradation product levels, and recently, using thromboelastometry. Although hyperfibrinolysis is observed in patients with severe isolated traumatic brain injury (TBI) on arrival at the emergency department (ED), it is unclear which factors induce hyperfibrinolysis. The present study aimed to investigate the factors associated with hyperfibrinolysis in patients with isolated severe TBI.Methods: We conducted a multicentre retrospective review of data for adult trauma patients with an injury severity score ≥ 16, and selected patients with isolated TBI (TBI group) and extra-cranial trauma (non-TBI group). The TBI group included patients with an abbreviated injury score (AIS) for the head ≥ 4 and an extra-cranial AIS < 2. The non-TBI group included patients with an extra-cranial AIS ≥ 3 and head AIS < 2. Hyperfibrinolysis was defined as a D-dimer level ≥ 38 mg/L on arrival at the ED. We evaluated the relationships between hyperfibrinolysis and injury severity/tissue injury/tissue perfusion in TBI patients by comparing them with non-TBI patients.Results: We enrolled 111 patients in the TBI group and 126 in the non-TBI group. In both groups, patients with hyperfibrinolysis had more severe injuries and received transfusion more frequently than patients without hyperfibrinolysis. Tissue injury, evaluated on the basis of lactate dehydrogenase and creatine kinase levels, was associated with hyperfibrinolysis in both groups. Among patients with TBI, the mortality rate was higher in those with hyperfibrinolysis than in those without hyperfibrinolysis. Tissue hypoperfusion, evaluated on the basis of lactate level, was associated with hyperfibrinolysis in only the non-TBI group. Although the increase in lactate level was correlated with the deterioration of coagulofibrinolytic variables (prolonged prothrombin time and activated partial thromboplastin time, decreased fibrinogen levels, and increased D-dimer levels) in the non-TBI group, no such correlation was observed in the TBI group.Conclusions: Hyperfibrinolysis is associated with tissue injury and trauma severity in TBI and non-TBI patients. However, tissue hypoperfusion is associated with hyperfibrinolysis in non-TBI patients, but not in TBI patients. Tissue hypoperfusion may not be a prerequisite for the occurrence of hyperfibrinolysis in patients with isolated TBI. [ABSTRACT FROM AUTHOR]

Published
2017
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33. Development of Novel Criteria of the "Lethal Triad" as an Indicator of Decision Making in Current Trauma Care: A Retrospective Multicenter Observational Study in Japan.

Author

Akira Endo, Atsushi Shiraishi, Yasuhiro Otomo, Shigeki Kushimoto, Daizoh Saitoh, Mineji Hayakawa, Hiroshi Ogura, Kiyoshi Murata, Akiyoshi Hagiwara, Junichi Sasaki, Tetsuya Matsuoka, Toshifumi Uejima, Naoto Morimura, Hiroyasu Ishikura, Munekazu Takeda, Naoyuki Kaneko, Hiroshi Kato, Daisuke Kudo, Takashi Kanemura, and Takayuki Shibusawa

Published
2016
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34. HIGH D-DIMER LEVELS PREDICT A POOR OUTCOME IN PATIENTS WITH SEVERE TRAUMA, EVEN WITH HIGH FIBRINOGEN LEVELS ON ARRIVAL: A MULTICENTER RETROSPECTIVE STUDY.

Author

Mineji Hayakawa, Kunihiko Maekawa, Shigeki Kushimoto, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogura, Tetsuya Matauoka, Toshifumi Uejima, Naoto Morimura, Hiroyasu Ishikura, Akiyoshi Hagiwara, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Daisuke Kudo, Takashi Kanemura, Takayuki Shibusawa, Shintaro Furugori, Yoshihiko Nakamura, and Atsushi Shiraishi

Published
2016
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