JaLCDOI 10.18926/AMO/54814
フルテキストURL 70_6_497.pdf
著者 Hikasa, Yukiko| Hayashi, Masao| Suzuki, Satoshi| Morimatsu, Hiroshi|
抄録 A 32-year-old woman, pregnant with twins, presented with a chief complaint of general fatigue. Her general condition had rapidly deteriorated since her last visit to the primary obstetrician; the patient was then referred to our hospital because of suspected fetal death. She underwent emergency cesarean section because fetal death had indeed occurred, and she was then admitted to the intensive care unit (ICU). On ICU admission, she was found to be in shock. Laboratory analysis revealed extreme hemoconcentration and a low albumin level, and initially, septic shock with obstetric complications was suspected. However, because she did not respond to conventional therapy but instead, rapidly developed severe generalized edema, systemic capillary leak syndrome (SCLS) was diagnosed. The patient remained in shock for several days until undergoing plasma exchange (PE), despite some earlier empirical treatments. She eventually recovered from profound shock status and was discharged from the ICU without sequelae. Among potentially effective treatments, PE seemed to be the most reasonable choice for the treatment of her SCLS.
キーワード systemic capillary leak syndrome plasma exchange pregnancy
Amo Type Case Report
発行日 2016-12
出版物タイトル Acta Medica Okayama
70巻
6号
出版者 Okayama University Medical School
開始ページ 497
終了ページ 501
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28003676
JaLCDOI 10.18926/AMO/54809
フルテキストURL 70_6_461.pdf
著者 Shiozaki, Kyoko| Morimatsu, Hiroshi| Matsusaki, Takashi| Iwasaki, Tatsuo|
抄録 Many patients suffer from postoperative serious adverse events (SAEs). Here we sought to determine the incidence of SAEs, assess the accuracy of currently used scoring systems in predicting postoperative SAEs, and determine whether a combination of scoring systems would better predict postoperative SAEs. We prospectively evaluated patients who underwent major surgery. We calculated 4 scores: American Society of Anesthesiologists physical status (ASA-PS) score, the Charlson Score, the POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) score, and the Surgical Apgar Score (SAS). We assessed the occurrence of SAEs. We assessed the association between each score and SAEs. We combined these scoring systems to find the best combination to predict the occurrence of SAEs. Among 284 patients, 43 suffered SAEs. All scoring systems could predict SAEs. However, their predictive power was not high (the area under the receiver operating characteristic curves [AUROC] 0.6-0.7). A combination of the ASA-PS score and the SAS was the most predictive of postoperative SAEs (AUROC 0.714). The incidence of postoperative SAEs was 15.1 . The combination of the ASA-PS score and the SAS may be a useful tool for predicting postoperative serious adverse events after major surgery.
キーワード serious adverse events preoperative assessment intraoperative assessment ASA-PS surgical Apgar score
Amo Type Original Article
発行日 2016-12
出版物タイトル Acta Medica Okayama
70巻
6号
出版者 Okayama University Medical School
開始ページ 461
終了ページ 467
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28003671
JaLCDOI 10.18926/AMO/54808
フルテキストURL 70_6_455.pdf
著者 Tanino, Masaaki| Kobayashi, Motomu| Sasaki, Toshihiro| Takata, Ken| Takeda, Yoshimasa| Mizobuchi, Satoshi| Morita, Kiyoshi| Nagai, Taku| Morimatsu, Hiroshi|
抄録 Postoperative cognitive dysfunction (POCD) occurs in nearly one-third of patients after non-cardiac surgery. Many animal behavior studies have investigated the effect of general anesthesia on cognitive function. However, there have been no studies examining the effects on working memory specifically, with a focus on the retention of working memory. We demonstrate here that isoflurane anesthesia induces deficits in the retention of spatial working memory in rats, as revealed by an increase in isoflurane-induced across-phase errors in the delayed spatial win-shift (SWSh) task with a 30-min delay in an 8-arm radial arm maze on post-anesthesia days (PADs) 1,2,4, and 10. A post-hoc analysis revealed a significant increase in across-phase errors on PAD 1 and recovery on PAD 10 in the isoflurane group. In contrast, within-phase errors independent of the retention of working memory were unaffected by isoflurane. These results demonstrate that isoflurane anesthesia transiently impairs the retention of spatial working memory in rats.
キーワード postoperative cognitive dysfunction isoflurane spatial working memory retention delayed spatial win-shift task
Amo Type Original Article
発行日 2016-12
出版物タイトル Acta Medica Okayama
70巻
6号
出版者 Okayama University Medical School
開始ページ 455
終了ページ 460
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28003670
JaLCDOI 10.18926/AMO/53027
フルテキストURL 68_6_375.pdf
著者 Yamanaka, Reiko| Soga, Yoshihiko| Moriya, Yoshie| Okui, Akemi| Takeuchi, Tetsuo| Sato, Kenji| Morimatsu, Hiroshi| Morita, Manabu|
抄録 We encountered a 74-year-old male patient with tongue laceration after convulsive seizures under intensive care. The tongue showed severe swelling, and the right ventral surface had been lacerated by his isolated and pointed right lower canine. Our university hospital has established a perioperative management center, and is promoting interprofessional collaboration, including dentists, in perioperative management. Dentists collaborating in the perioperative management center took dental impressions, with the support of anesthesiologists who opened the patientʼs jaw under propofol sedation, to produce a mouth protector. By raising the patientʼs bite, the completed mouth protector prevented the isolated tooth from contacting the tongue and protected the lacerated wound. Use of the mouth protector prevented the lacerated tongue from coming into contact with the pointed tooth, and the tongue healed gradually. These findings underscore that interprofessional collaboration including dentists can improve the quality of medical care.
キーワード mouth protector tongue laceration
Amo Type Case Report
発行日 2014-12
出版物タイトル Acta Medica Okayama
68巻
6号
出版者 Okayama University Medical School
開始ページ 375
終了ページ 378
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25519032
Web of Sience KeyUT 000346882200008
JaLCDOI 10.18926/AMO/53023
フルテキストURL 68_6_339.pdf
著者 Nishie, Hiroyuki| Mizobuchi, Satoshi| Suzuki, Etsuji| Sato, Kenji| Toda, Yuichiro| Matsuoka, Junji| Morimatsu, Hiroshi|
抄録 The main purpose of this study was to determine the relationships between Japanese individualsʼ interest in living wills and their preferred end-of-life care and death locations. Questionnaires were mailed to 1,000 individuals aged ァ50 to measure these 2 factors. We examined the associations between the respondentsʼ characteristics and their preferred care and death locations by using multinomial logistic regression models. The response rate was 74%. Home was the most frequently preferred place for end-of-life care (64%), and a palliative care unit (PCU) was the most commonly preferred place to die (51%). Living will interest was associated with a preference for care (odds ratio [OR] 4.74, 95% confidence interval [CI] 1.95-12.1) and death (OR 2.75, 95% CI 1.70-4.47) in a PCU rather than a hospital, but it was not associated with the choice between receiving care or dying at home instead of a hospital. We must consider why Japanese people think home death is impracticable. The Japanese palliative care system should be expanded to meet patientsʼ end-of-life needs, and this includes not only facilitating home care but also increasing access to PCU care.
キーワード advance healthcare directive living will end-of-life care palliative care unit place of death
Amo Type Original Article
発行日 2014-12
出版物タイトル Acta Medica Okayama
68巻
6号
出版者 Okayama University Medical School
開始ページ 339
終了ページ 348
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25519028
Web of Sience KeyUT 000346882200004
関連URL http://ousar.lib.okayama-u.ac.jp/metadata/53134
著者 Tomotsuka, Naoto| Kaku, Ryuji| Obata, Norihiko| Matsuoka, Yoshikazu| Kanzaki, Hirotaka| Taniguchi, Arata| Muto, Noriko| Omiya, Hiroki| Itano, Yoshitaro| Sato, Tadasu| Ichikawa, Hiroyuki| Mizobuchi, Satoshi| Morimatsu, Hiroshi|
発行日 2014-07-11
出版物タイトル Journal of Pain Research
7巻
資料タイプ 学術雑誌論文
著者 Tani, Makiko| Morimatsu, Hiroshi| Takatsu, Fumiaki| Morita, Kiyoshi|
発行日 2012
出版物タイトル The Scientific World Journal
2012巻
資料タイプ 学術雑誌論文
著者 Kosaka, Junko| Morimatsu, Hiroshi| Takahashi, Toru| Shimizu, Hiroko| Kawanishi, Susumu| Omori, Emiko| Endo, Yasumasa| Tamaki, Naofumi| Morita, Manabu| Morita, Kiyoshi|
発行日 2013-05-07
出版物タイトル PLoS ONE
8巻
5号
資料タイプ 学術雑誌論文
著者 Matsumi, Junya| Morimatsu, Hiroshi| Matsusaki, Takashi| Kaku, Ryuji| Shimizu, Hiroko| Takahashi, Toru| Yagi, Takahito| Matsumi, Masaki| Morita, Kiyoshi|
発行日 2012-02
出版物タイトル International Journal of Molecular Medicine
29巻
2号
資料タイプ 学術雑誌論文