Updated on 2025/06/28

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写真a

 
Shunsuke Takaki
 
Organization
Yokohama City University Hospital Intensive Care Departmen Associate Professor
Title
Associate Professor
Contact information
メールアドレス
Profile
集中治療室における業務効率の改善、日本版の遠隔集中治療の構築が主な研究テーマである。また、生体情報データや電子カルテのデータを用いた新たな診療支援ツールの構築、医療機器開発を目的とした研究を行っている。
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Degree

  • 医学博士 ( 横浜市立大学 )

Research Interests

  • Early Warning Score

  • Tele-ICU

  • Rapid Response System

Research Areas

  • Life Science / Anesthesiology

  • Life Science / Medical management and medical sociology  / Telemedicine

  • Life Science / Emergency medicine  / Intensive Care

Education

  • Yokohama City University   Medical Department

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Research History

  • Yokohama City University Hospital   Intensive Care Unit   Associate Professor

    2015.6

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  • Yokohama City University Hospital   Intensive Care Unit   Assistant Professor

    2012.6 - 2015.6

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  • Prince Of Wales Hospital   Intensive Care Unit   Clinical Research Fellow

    2011.10 - 2012.6

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  • Institut Jantung Negara in Malaysia   Department of Anesthesiology   Clinical Fellow

    2010.6 - 2011.6

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  • Yokohama City University Medical Center   Advanced Emergency Medical Center   Assistant Professor

    2008.6 - 2010.4

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  • Yokohama City University Hospital   Assistant Professor

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Professional Memberships

  • JAPANESE SOCIETY OF ANESTHESIOLOGISTS

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  • THE JAPANESE SOCIETY OF INTENSIVE CARE MEDICINE

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  • JAPANESE ASSOCIATION FOR ACUTE MEDICINE

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  • JAPAN SOCIETY OF RESPIRATORY CARE MEDICINE

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Committee Memberships

  • 日本集中治療医学会   評議員  

    2016.4   

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    Committee type:Academic society

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Papers

  • A multi‐nudge‐based behavioural insight into ward nurses' respiratory rate measurement: An observational study

    Shunsuke Takaki, Koji Hara, Ayana Motoyama, Yuki Kawana, Makoto Kuroki, Shusaku Sasaki

    Journal of Clinical Nursing   2025.3

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1111/jocn.17396

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  • 身体活動が制限される隔離環境でも重症患者の早期の理学療法士の介入は1年後の身体機能障害を抑制する

    奥 真哉, 中村 謙介, 出井 真史, 高木 俊介, 東條 健太郎, 西田 岳史, 畠山 淳司, 劉 啓文

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S915 - S915   2024.9

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  • 巨大縦隔腫瘍による気管圧排から換気困難となったが体外式膜型人工肺により救命し得た一例

    柏木 静, 山本 さおり, 横山 暢幸, 出井 真史, 藤本 寛子, 横瀬 真志, 中村 謙介, 高木 俊介

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S564 - S564   2024.9

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  • 遠隔モニタリングの魅力と可能性 重症系病床における遠隔モニタリングによる医療の質向上の取り組み

    出井 真史, 高木 俊介, 横山 暢幸, 横瀬 真志, 柏木 静, 酒井 洋平, 中村 謙介

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S459 - S459   2024.9

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  • 遠隔ICUシステム導入後の看護師仕事満足度調査

    桝井 優, 出井 真史, 高木 俊介, 川名 由貴, 元山 文菜, 中村 謙介, 横瀬 真志, 柏木 静, 横山 暢幸

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S569 - S569   2024.9

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  • COVID19患者における集中治療室入室中の栄養療法がPICSに及ぼす影響について 多施設前向き研究

    菅沼 進也, 川畑 慶一郎, 横山 暢幸, 出井 真史, 柏木 静, 東條 健太郎, 高木 俊介, 中村 謙介

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S669 - S669   2024.9

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  • 心臓血管外科術後の急性腎障害発生予測モデルの構築

    横山 暢幸, 高木 俊介, 三角 俊裕, 出井 真史, 柏木 静, 横瀬 真志, 中村 謙介, 後藤 隆久

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S591 - S591   2024.9

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  • COVID-19感染患者における入院時栄養状態とLong-COVIDの関係

    川畑 慶一郎, 菅沼 進也, 横山 暢幸, 柏木 静, 横瀬 真志, 出井 真史, 東條 健太郎, 高木 俊介, 中村 謙介

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S836 - S836   2024.9

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  • 集中治療室入院患者の気管切開は集中治療後症候群のリスク因子になり得る

    吉野 主理, 川上 大裕, 畠山 淳司, 早川 桂, 奥 真哉, 出井 真史, 高木 俊介, 東條 健太郎, 中村 謙介

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S671 - S671   2024.9

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  • Creatinine Reduction Ratio Is a Prognostic Factor for Acute Kidney Injury following Cardiac Surgery with Cardiopulmonary Bypass: A Single-Center Retrospective Cohort Study

    Akiko Anzai, Shunsuke Takaki, Nobuyuki Yokoyama, Shizuka Kashiwagi, Masashi Yokose, Takahisa Goto

    Journal of Clinical Medicine   2023.12

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    DOI: 10.3390/jcm13010009

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  • 尿路感染による敗血症性ショックに,心筋虚血による二次性の心原性ショックを合併した1症例

    酒井 洋平, 長嶺 祐介, 出井 真史, 横山 暢幸, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    麻酔   72 ( 12 )   1145 - 1148   2023.12

  • Measurement accuracy of a microwave doppler sensor beneath the mattress as a continuous respiratory rate monitor: a method comparison study. International journal

    Hiroyuki Tanaka, Masashi Yokose, Shunsuke Takaki, Takahiro Mihara, Yusuke Saigusa, Takahisa Goto

    Journal of clinical monitoring and computing   2023.10

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    PURPOSE: Non-contact continuous respiratory rate monitoring is preferred for early detection of patient deterioration. However, this technique is under development; a gold standard respiratory monitor has not been established. Therefore, this prospective observational method comparison study aimed to compare the measurement accuracy of a non-contact continuous respiratory rate monitor, a microwave Doppler sensor positioned beneath the mattress, with that of other monitors. METHODS: The respiratory rate of intensive care unit patients was simultaneously measured using a microwave Doppler sensor, capnography, thoracic impedance pneumography, and a piezoelectric sensor beneath the mattress. Bias and 95% limits of agreement between the respiratory rate measured using capnography (standard reference) and that measured using the other three methods were calculated using Bland-Altman analysis for repeated measures. Clarke error grid (CEG) analysis evaluated the sensor's ability to assist in correct clinical decision-making. RESULTS: Eighteen participants were included, and 2,307 data points were analyzed. The bias values (95% limits of agreement) of the microwave Doppler sensor, thoracic impedance pneumography, and piezoelectric sensor were 0.2 (- 4.8 to 5.2), 1.5 (- 4.4 to 7.4), and 0.4 (- 4.0 to 4.8) breaths per minute, respectively. Clinical decisions evaluated using CEG analyses were correct 98.1% of the time for the microwave Doppler sensor, which was similar to the performance of the other devices. CONCLUSION: The microwave Doppler sensor had a small bias but relatively low precision, similar to other devices. In CEG analyses, the risk of each monitor leading to inadequate clinical decision-making was low. TRIAL REGISTRATION NUMBER: UMIN000038900, February 1, 2020.

    DOI: 10.1007/s10877-023-01081-7

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  • Clinical features and prognosis of toxic epidermal necrolysis requiring intensive care: A retrospective descriptive single-center study Reviewed

    Yohei Sakai, Yusuke Nagamine, Masashi Yokose, Nobuyuki Yokoyama, Tasuku Yoshida, Shizuka Kashiwagi, Shunsuke Takaki, Takahisa Goto

    Burns Open   2023.10

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    DOI: 10.1016/j.burnso.2023.09.001

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  • Impact of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome during Intensive Care Admission on Each Post-Intensive Care Syndrome Component in a PICS Clinic. International journal

    Shinya Suganuma, Masafumi Idei, Hidehiko Nakano, Yasuaki Koyama, Hideki Hashimoto, Nobuyuki Yokoyama, Shunsuke Takaki, Kensuke Nakamura

    Journal of clinical medicine   12 ( 16 )   2023.8

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    BACKGROUND: Persistent inflammation, immunosuppression, and catabolism syndrome (PIICS) is known as a prolonged immunodeficiency that occurs after severe infection. Few studies have demonstrated a direct relationship between PIICS and physical dysfunction in post-intensive care syndrome (PICS). We herein investigated how each component of PICS was affected by the diagnosis of PIICS during hospitalization and examined the relationship between PIICS and PICS using PICS assessments performed at the Hitachi General Hospital PICS Clinic. METHODS: The 273 patients who visited the PICS clinic at one month after discharge from the ICU at Hitachi General Hospital were included in the study. We used the diagnostic criteria for PIICS described in previous studies. At least two of the following blood test values on day 14 of hospitalization had to be met for a diagnosis of PIICS: C-reactive protein (CRP) > 2.0 mg/dL, albumin (Alb) < 3.0 g/dL, and lymphocytes (Lym) < 800/μL. Blood test values closest to day 14 out of 11-17 days of hospitalization were used. The primary outcome was a Barthel Index (BI) < 90, while secondary outcomes were the results of various PICS assessments, including mental and cognitive impairments, performed at the PICS clinic. We supplemented missing data with multiple imputations by chained equations. We performed a nominal logistic regression analysis with age, sex, BMI, SOFA, and the presence of PIICS as variables for BI < 90. RESULTS: Forty-three out of two hundred seventy-three PICS outpatients met the diagnostic criteria for PIICS during hospitalization. In comparisons with non-PIICS patients, significantly higher severity scores for APACHE II and SOFA and a longer hospital stay were observed in PIICS patients, suggesting a higher clinical severity. The primary outcome, BI, was lower in the PIICS group (97.5 (58.5, 100) vs. 100 (95, 100), p = 0.008), as were the secondary outcomes (FSS-ICU: 35 (31, 35) vs. 35 (35, 35), MRC score: 55 (50.25, 58) vs. 58 (53, 60), grip strength: 16.45 (9.2, 25.47) vs. 20.4 (15.3, 27.7)). No significant differences were noted in mental or cognitive function assessments, such as HADS, IES-R, and SMQ. A multivariable analysis supplemented with missing data revealed that PIICS (odds ratio: 1.23 (1.08-1.40 p = 0.001) and age (odds ratio: 1.007 (1.004-1.01), p < 0.001) correlated with BI < 90, independent of clinical severity such as sequential organ failure assessment (SOFA). Similar results were obtained in the sensitivity analysis excluding missing data. CONCLUSIONS: The present study revealed a strong relationship between PIICS and post-discharge PICS physical dysfunction in patients requiring intensive care.

    DOI: 10.3390/jcm12165427

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  • Stomach position evaluated using computed tomography is related to successful post-pyloric enteral feeding tube placement in critically ill patients: a retrospective observational study. International journal

    Masashi Yokose, Shunsuke Takaki, Yusuke Saigusa, Takahiro Mihara, Yoshinobu Ishiwata, Shingo Kato, Keiichi Horie, Takahisa Goto

    Journal of intensive care   11 ( 1 )   25 - 25   2023.5

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    BACKGROUND: Post-pyloric enteral feeding reduces respiratory complications and shortens the duration of mechanical ventilation. Blind placement of post-pyloric enteral feeding tubes (EFT) in patients with critical illnesses is often the first-line method because endoscopy or fluoroscopy cannot be easily performed at bedside; however, difficult placements regularly occur. We reported an association between the stomach position caudal to spinal level L1-L2, evaluated by abdominal radiographs after placement, and difficult placement; however, this method could not indicate difficulty before EFT placement. The aim of our study was to evaluate the association between stomach position, estimated using computed tomography (CT) images taken before the blind placement of the post-pyloric EFT, and the difficulty of EFT placement. METHODS: Data from patients aged ≥ 20 years who underwent post-pyloric EFT in our intensive care unit were obtained retrospectively. Logistic regression analysis was used to evaluate the association between successful initial EFT placement and explanatory variables, including stomach position estimated by CT. Two cut-off values were used: caudal to L1-L2 based on a previous study and the best cut-off value calculated by the receiver operating characteristic curve. Variable selection was performed backward stepwise using Akaike's Information Criterion. RESULTS: Of the total of 453 patients who were enrolled, the success rate of the initial EFT placement was 43.5%. The adjusted odds ratio for successful initial EFT placement of the stomach position caudal to L1-L2 was 0.61 (95% confidence interval: 0.41-1.07). Logistic regression analysis, including the stomach position caudal to L2-L3, calculated as the best cut-off value, indicated that stomach position was an independent factor for failure of initial EFT placement (adjusted odds ratio, 0.55; 95% confidence interval: 0.33-0.91). CONCLUSIONS: Stomach position evaluated using CT images was associated with successful initial post-pyloric EFT placement. The best cut-off value of the greater curvature of the stomach to predict the success or failure of the first attempt was spinal level L2-L3. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN000046986; February 28, 2022). https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000052151.

    DOI: 10.1186/s40560-023-00673-4

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  • 集学的治療により救命しえた妊婦の急性肝不全の一例

    寺田 裕作, 出井 真史, 横瀬 真志, 柏木 静, 横山 暢幸, 閻 碩, 野上 麻子, 高木 俊介

    日本集中治療医学会雑誌   29 ( Suppl.1 )   696 - 696   2022.11

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  • 集中治療でのICTとAI活用に向けた先進的活用方法を考える データ利活用による遠隔医療と集中治療の融合

    高木 俊介, 大下 慎一郎, 齊藤 健一, 堤 貴彦, 神尾 直, 長嶺 祐介, 飯塚 悠祐, 松村 洋輔, 橋本 悟

    日本集中治療医学会雑誌   29 ( Suppl.1 )   364 - 364   2022.11

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  • vascular slingに合併した先天性気管狭窄症に対する人工呼吸管理の1症例

    濱田 貴子, 菅原 陽, 長嶺 祐介, 桑原 香折, 安西 晃子, 横山 暢幸, 柏木 静, 高木 俊介, 後藤 隆久

    麻酔   71 ( 7 )   776 - 779   2022.7

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  • 妊娠33週の肺水腫を契機に診断された左房心臓腫瘍の周術期・集中治療管理の経験

    桑原 香折, 菅原 陽, 長嶺 祐介, 安西 晃子, 横山 暢幸, 濱田 貴子, 高木 俊介, 後藤 隆久

    麻酔   71 ( 6 )   601 - 605   2022.6

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  • 結腸膀胱瘻に起因した高クロール性代謝性アシドーシスの一例

    田中 宏幸, 長嶺 祐介, 吉田 輔, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   29 ( 3 )   229 - 230   2022.5

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  • Multivariate analysis of factors associated with first-pass success in blind placement of a post-pyloric feeding tube: a retrospective study. International journal

    Kohei Kurisawa, Masashi Yokose, Hiroyuki Tanaka, Takahiro Mihara, Shunsuke Takaki, Takahisa Goto

    Journal of intensive care   9 ( 1 )   59 - 59   2021.10

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    BACKGROUND: Trans-jejunal nutrition via a post-pyloric enteral feeding tube has a low risk of aspiration or reflux; however, placement of the tube using the blind method can be difficult. Assistive devices, such as fluoroscopy or endoscopy, are useful but may not be suitable for patients with hemodynamic instability or severe respiratory failure. The aim of this study was to explore factors associated with first-pass success in the blind placement of post-pyloric enteral feeding tubes in critically ill patients. METHODS: Data were obtained retrospectively from the medical records of adult patients who had a post-pyloric enteral feeding tube placed in the intensive care unit between January 1, 2012, and December 31, 2018. Logistic regression analysis was performed to assess the association between first-pass success and the independent variables. For logistic regression analysis, the following 13 variables were defined as independent variables: age, sex, height, fluid balance from baseline, use of sedatives, body position during the procedure, use of cardiac assist devices, use of prokinetic agents, presence or absence of intestinal peristalsis, postoperative cardiovascular surgery, use of renal replacement therapy, serum albumin levels, and position of the greater curvature of the stomach in relation to spinal levels L1 - L2. RESULTS: Data obtained from 442 patients were analyzed. The first-pass success rate was 42.8% (n = 189). Logistic regression analysis demonstrated that the position of the greater curvature of the stomach cephalad to L1 - L2 was only associated with successful placement (odds ratio for first-pass success, 0.62; 95% confidence interval: 0.40 - 0.95). CONCLUSIONS: In critically ill patients, the position of the greater curvature of the stomach caudal to L1 - L2 may be associated with a lower first-pass success rate of the blind method for post-pyloric enteral feeding tube placement. Further studies are needed to verify our results because the position of the stomach was estimated by radiographs after enteral feeding tube placement. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry (UMIN000036549; April 20, 2019).

    DOI: 10.1186/s40560-021-00577-1

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  • 声門狭窄を合併した再発性多発軟骨炎患者の周術期気道管理の経験

    菊西 陽香, 井上 真光人, 山本 匠, 東條 健太郎, 吉田 輔, 横山 暢幸, 横瀬 真志, 入江 友哉, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( Suppl.2 )   362 - 362   2021.9

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  • 急性腎障害の診断と管理:最新の話題 時系列データを用いた関数ロジスティックモデルによるAKIアラートの構築

    高木 俊介, 三角 俊裕, 根本 貴志, 後藤 隆久

    日本集中治療医学会雑誌   28 ( Suppl.2 )   287 - 287   2021.9

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  • 化学療法(mFOLFOX療法)施行中に認めた5-fluorouracil(FU)による乳酸アシドーシス、著明な高アンモニア血症に対して血液透析を施行した一例

    今井 祥子, 菅原 陽, 田中 宏幸, 横山 暢幸, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( 4 )   289 - 290   2021.7

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  • 症例報告 肺高血圧を合併した衝心脚気

    田中 宏幸, 菅原 陽, 今井 祥子, 吉田 輔, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( 4 )   294 - 295   2021.7

  • 症例報告 肺高血圧を合併した衝心脚気

    田中 宏幸, 菅原 陽, 今井 祥子, 吉田 輔, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( 4 )   294 - 295   2021.7

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  • Evaluation of respiratory rate monitoring using a microwave Doppler sensor mounted on the ceiling of an intensive care unit: a prospective observational study. International journal

    Hiroyuki Tanaka, Masashi Yokose, Shunsuke Takaki, Takahiro Mihara, Yusuke Saigusa, Takahisa Goto

    Journal of clinical monitoring and computing   2021.6

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    Continuous monitoring of the respiratory rate is crucial in an acute care setting. Contact respiratory monitoring modalities such as capnography and thoracic impedance pneumography are prone to artifacts, causing false alarms. Moreover, their cables can restrict patient behavior or interrupt patient care. A microwave Doppler sensor is a novel non-contact continuous respiratory rate monitor. We compared respiratory rate measurements performed with a microwave Doppler sensor mounted on the ceiling of an intensive care unit with those obtained by conventional methods in conscious and spontaneously breathing patients. Participants' respiratory rate was simultaneously measured by visual counting of chest wall movements for 60 s; a microwave Doppler sensor; capnography, using an oxygen mask; and thoracic impedance pneumography, using electrocardiogram electrodes. Bland-Altman analysis for repeated measures was performed to calculate bias and 95% limits of agreement between the respiratory rate measured by visual counting (reference) and that measured by each of the other methods. Among 52 participants, there were 336 (microwave Doppler sensor), 275 (capnography), and 336 (thoracic impedance pneumography) paired respiratory rate data points. Bias (95% limits of agreement) estimates were as follows: microwave Doppler sensor, 0.3 (- 6.1 to 6.8) breaths per minute (bpm); capnography, - 1.3 (- 8.6 to 6.0) bpm; and thoracic impedance pneumography, 0.1 (- 4.4 to 4.7) bpm. Compared to visual counting, the microwave Doppler sensor showed small bias; however, the limits of agreement were similar to those observed in other conventional methods. Our monitor and the conventional ones are not interchangeable with visual counting.Trial registration number: UMIN000032021, March/30/2018.

    DOI: 10.1007/s10877-021-00733-w

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  • Mortality and risk factors on admission in toxic epidermal necrolysis: A cohort study of 59 patients. International journal

    Tomoya Watanabe, Hirofumi Go, Yusuke Saigusa, Naoko Takamura, Yuko Watanabe, Yumiko Yamane, Michiru Totsuka, Hideyuki Ishikawa, Kazuko Nakamura, Setsuko Matsukura, Takeshi Kambara, Shunsuke Takaki, Yukie Yamaguchi, Michiko Aihara

    Allergology international : official journal of the Japanese Society of Allergology   70 ( 2 )   229 - 234   2021.4

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    BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening disorders characterized by widespread epidermal necrosis of the skin and mucosa. The severity-of-illness scoring system for TEN (SCORTEN) was widely used since 2000 as a standard prognostic tool consisting of seven clinical values. METHODS: To evaluate the prognosis using current treatments and risk factors for mortality, we retrospectively analyzed 59 cases of TEN, including SJS/TEN overlap treated in two university hospitals from January 2000 to March 2020. RESULTS: The mortality rate of TEN was 13.6% (8/59). All patients treated with high-dose steroid administration in combination with plasma exchange and/or immunoglobulin therapy recovered. Logistic regression analysis showed nine clinical composite scores, namely: heart rate (≧120 bpm), malignancy present, percentage of body surface area with epidermal detachment (>10%), blood urea nitrogen (>28 mg/dL), serum bicarbonate level (<20 mEq/L), serum glucose level (>252 mg/dL), age (≧71 years), the interval between disease onset and treatment initiation at the specialty hospital (≧8 days), and respiratory disorder within 48 h after admission. The receiver operating characteristic curves confirmed a high potential for predicting the prognosis of TEN. CONCLUSIONS: Recent developments in treatment strategies have contributed to the improved prognosis of TEN patients. A modified severity scoring model composed of nine scores may be helpful in the prediction of TEN prognosis in recent patients. Further large-scale studies are needed to confirm mortality findings to improve prognostication in patients with TEN.

    DOI: 10.1016/j.alit.2020.11.004

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  • ICU入室患者におけるベルト電極式骨格筋電気刺激療法の安全性に関する検討

    佐伯 拓也, 横瀬 真志, 高木 俊介, 中村 健

    日本集中治療医学会雑誌   27 ( Suppl. )   664 - 664   2020.9

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  • 呼吸管理における遠隔医療の可能性について

    高木 俊介, 田中 宏幸, 横瀬 真志

    人工呼吸   37 ( 1 )   46 - 52   2020.5

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  • A question is "what are the optimal targets for anticoagulant therapies?" Reviewed International journal

    Nobuyuki Yokoyama, Shunsuke Takaki, Masashi Yokose, Kaori Kuwabara, Akiko Anzai, Takako Hamada, Shizuka Kashiwagi, Kenta Okamura, Yoh Sugawara, Takahisa Goto

    Journal of intensive care   8   17 - 17   2020

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    A high mortality rate is found among septic patients with disseminated intravascular coagulation (DIC). Anticoagulants have been used for treating septic DIC especially in Japanese clinical settings; however, their effectiveness is quite controversial across studies. According to several randomized controlled trials and meta-analyses, antithrombin and recombinant thrombomodulin had no therapeutic benefit in the treatment of sepsis. However, the majority of the previous research did not discuss "septic DIC" but simply "sepsis", and some reviews showed that anticoagulants were benefit only in septic DIC. Although immunothrombosis plays an important role in early host defense, it can lead to DIC and organ failure if dysregulated. Therefore, we advocate anticoagulant therapies might have beneficial effects, but research on optimal patient selection is currently lacking.

    DOI: 10.1186/s40560-020-0434-9

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  • The Difference Between Set and Delivered Tidal Volume: A Lung Simulation Study. International journal

    Yoshikazu Yamaguchi, Tetsuya Miyashita, Yuko Matsuda, Makoto Sasaki, Shunsuke Takaki, Stephani S Kim, Joseph D Tobias, Takahisa Goto

    Medical devices (Auckland, N.Z.)   13   205 - 211   2020

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    Background: Precise control of tidal volume is one of the keys in limiting ventilator-induced lung injury and ensuring adequate ventilation in mechanically ventilated neonates. The aim of the study was to compare the tidal volume (mVT) measured from the expiratory limb of the ventilator with the actual tidal volume (aVT) that would be delivered to the patient using a lung model to simulate a neonate. Methods: This study was conducted using the ASL5000 lung simulator. Three combinations of parameters were set: resistance (cmH2O/L/sec) and compliance (mL/cmH2O) of 50 and 2 (Group 1), 100 and 1 (Group 2), and 150 and 0.5 (Group 3), respectively. The ASL5000 was connected to each of the ventilators including one anesthesia machine ventilator (Drager Fabius GS) and two ICU ventilators (Servo-i Universal and Evita Infinity V500). Each ventilator was evaluated with a set tidal volume of 30 mL (sVT) and a respiratory rate of 25 breathes/minute in both the volume-controlled ventilation (VCV) and dual-controlled ventilation (DCV) modes. Results: The discrepancies between sVT, mVT and aVT were highest with the Fabius anesthesia machine ventilator and increased in the simulated lung injury groups. When comparing the ICU ventilators, the difference was greater the Servo-i and increased when using the DCV mode and with simulated lung injury. Conclusion: Accurate tidal volumes were achieved only with the Infinity ICU ventilator. This was true regardless of mode of ventilation and even during simulated lung injury.

    DOI: 10.2147/MDER.S259760

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  • Low hematocrit levels: a risk factor for long-term outcomes in patients requiring prolonged mechanical ventilation after cardiovascular surgery. A retrospective study. Reviewed

    Tsukinaga A, Takaki S, Mihara T, Okamura K, Isoda S, Kurahashi K, Goto T

    J Investig Med.   Sep 26 ( 2 )   392 - 396   2019.9

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    DOI: 10.1136/jim-2019-001122

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  • 働き方改革における遠隔ICUへの期待 労務軽減と医療の質向上(厚労科研補助金事業 研究班報告)

    松村 洋輔, 高木 俊介, 土井 研人, 大下 慎一郎, 長嶺 祐介, 橋本 悟

    日本救急医学会雑誌   30 ( 9 )   693 - 693   2019.9

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  • The perfusion index measured by the pulse oximeter affects the agreement between ClearSight and the arterial catheter-based blood pressures: A prospective observational study. Reviewed International journal

    Masashi Yokose, Takahiro Mihara, Masahiro Takaya, Takumi Yamamoto, Yusuke Saigusa, Shunsuke Takaki, Takahisa Goto

    PloS one   14 ( 7 )   e0219511   2019

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    BACKGROUND: ClearSight is a noninvasive arterial blood pressure monitor, but it remains unknown whether it is affected by the state of perfusion to the fingers. We investigated whether the lower perfusion index (PI) measured with a pulse oximeter, which reflects finger perfusion, would affect the agreement between arterial pressures measured with ClearSight versus those obtained with an arterial catheter. METHODS: Paired arterial pressure data (ClearSight and arterial catheter-based pressures) and PI values were prospectively obtained from 30 patients undergoing major abdominal surgery. The primary outcome was standard deviation (SD) of the bias (precision) of blood pressure between ClearSight and arterial catheter. The ratio of the adjusted SD of the bias between PI≤1 and PI>1 was calculated using the linear mixed-effects model. The secondary outcomes were the bias and the limits of agreement (LOA) between the two devices (repeated measures Bland-Altman analysis). RESULTS: We analyzed 6312 paired data points. The adjusted SD of bias in PI ≤1 compared with those in PI >1 was 1.4-fold (95% confidence interval: 1.3- to 1.4-fold) for systolic arterial pressure, 1.5-fold (95% confidence interval: 1.3- to 1.6-fold) for diastolic arterial pressure, and 1.3-fold (95% confidence interval: 1.2- to 1.5-fold) for mean arterial pressure. The bias (LOA) were as follows: systolic arterial pressure in the PI ≤1 and PI >1 groups, -3.5 (-35.4 to 28.4) mmHg and 2.2 (-19.9 to 24.3) mmHg, respectively; diastolic arterial pressure in the PI ≤1 and PI >1 groups, 13.1 (-5.1 to 31.3) mmHg and 9.0, (-2.6 to 20.6) mmHg, respectively; and mean arterial pressure in the PI ≤1 and PI >1 groups, 8.7 (-11.3 to 28.7) mmHg and 7.6 (-6.2 to 21.3) mmHg, respectively. CONCLUSIONS: PI ≤1 was associated with a large SD of the bias between the devices. The PI value could be a real-time indicator of ClearSight precision.

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  • Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery.

    Akito Tsukinaga, Takuma Maeda, Shunsuke Takaki, Nobuaki Michihata, Yoshihiko Ohnishi, Takahisa Goto

    Journal of anesthesia   32 ( 4 )   539 - 546   2018.8

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    PURPOSE: The aim of this study was to examine the relationship between FFP (fresh frozen plasma)/pRBC (packed red blood cell) transfusion ratio and outcomes in patients undergoing cardiovascular surgery. METHODS: This is a single center retrospective cohort study performed in a cardiovascular center. Patients undergoing cardiovascular surgery between January 2012 and October 2016 with or without massive transfusion (n = 1453). Patients' outcomes were compared based on FFP/pRBC transfusion ratio (FFP/pRBC > 1 or FFP/pRBC ≤ 1). RESULTS: In hospital mortality and rate of stroke and myocardial infarction was significantly higher in patients with less than 1 of FFP/pRBC transfusion ratio only in patients with massive transfusion (3.0 vs 8.8%, p = 0.001; 0.7 vs 6.4%, p < 0.001; 1.0 vs 3.2%, p = 0.047, respectively). CONCLUSIONS: Higher FFP/RBC ratio was associated with reduced risk of death, stroke and myocardial infarction only in patients with cardiovascular surgery receiving massive transfusion. Clinicians should be aware that judicious FFP replacement plays a critical role in the successful management of massive transfusion in cardiac surgery.

    DOI: 10.1007/s00540-018-2508-6

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  • Predictors of severe postoperative hyperglycemia after cardiac surgery in infants: a single-center, retrospective, observational study Reviewed

    Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto

    Journal of Anesthesia   32 ( 2 )   160 - 166   2018.4

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    DOI: 10.1007/s00540-017-2444-x

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  • PI値はClearSightによる心拍出量測定の正確性の指標となるか?

    横瀬 真志, 早川 翔, 田中 宏幸, 濱田 貴子, 吉田 輔, 高木 俊介, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   25 ( Suppl. )   [O72 - 5]   2018.2

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  • Comparison between High- and Low-Cost Transmission of Tele-Anesthesia in Japan. Reviewed

    Sugawara Y, Miyashita T, Mizuno Y, Nagamine Y, Miyazaki T, Kobayashi A, Tojo K, Iketani Y, Takaki S, Goto T

    Journal of healthcare engineering   2018   9615264   2018

  • CO2ナルコーシスを呈した肥満低換気症候群の患者を非侵襲的陽圧換気で管理した1例

    吉田 輔, 山口 嘉一, 松田 優子, 高木 俊介, 山口 修, 後藤 隆久

    臨床麻酔   41 ( 8 )   1157 - 1159   2017.8

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  • Hyperleukocytosis Complicated by Intracerebral Hemorrhage and Spurious Hypoxemia: A Case Report and Literature Review. Reviewed International journal

    Katakura Y, Yamaguchi Y, Miyashita T, Idei M, Yoshida T, Matsuda Y, Takaki S, Kamijo A, Yamaguchi O, Goto T

    A & A case reports   9 ( 6 )   159 - 161   2017.5

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    We present the management of a 15-year-old girl with acute myeloid leukemia who presented with massive hyperleukocytosis and neurological deficit due to intracerebral hemorrhage. Surgical intervention was considered but ultimately not undertaken because of the presence of massive hyperleukocytosis, thrombocytopenia, hypokalemia, and considerable discrepancy between the oxygen saturation values determined mechanically and by peripheral oximetry. Aggressive treatment of the hyperleukocytosis was immediately started, which improved the patient's overall condition and rendered surgical intervention unnecessary. This report shows that immediate treatment of massive hyperleukocytosis and critical interpretation of laboratory results in patients with hyperleukocytosis are warranted.

    DOI: 10.1213/XAA.0000000000000553

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  • Deep Breathing Improves End-Tidal Carbon Dioxide Monitoring of an Oxygen Nasal Cannula-Based Capnometry Device in Subjects Extubated After Abdominal Surgery Reviewed

    Shunsuke Takaki, Kenji Mizutani, Moeka Fukuchi, Tasuku Yoshida, Masahumi Idei, Yuko Matsuda, Yoshikazu Yamaguchi, Tetsuya Miyashita, Takeshi Nomura, Osamu Yamaguchi, Takahisa Goto

    RESPIRATORY CARE   62 ( 1 )   86 - 91   2017.1

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    DOI: 10.4187/respcare.04634

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  • Inhibition of Prolyl Hydroxylase Attenuates Fas Ligand-Induced Apoptosis and Lung Injury in Mice Reviewed

    Yusuke Nagamine, Kentaro Tojo, Takuya Yazawa, Shunsuke Takaki, Yasuko Baba, Takahisa Goto, Kiyoyasu Kurahashi

    AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY   55 ( 6 )   878 - 888   2016.12

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    DOI: 10.1165/rcmb.2015-0266OC

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  • ERCP中にガス塞栓によりCPAをきたした1症例

    片倉 友美, 山口 嘉一, 出井 真史, 吉田 輔, 高木 俊介, 野村 岳志, 山口 修, 後藤 隆久

    日本臨床麻酔学会誌   36 ( 6 )   S381 - S381   2016.10

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  • Difference in the spread of injectate between ultrasound guided pectoral nerve block I and II. A cadaver study Reviewed

    Masaru Kikuchi, Shunsuke Takaki, Takeshi Nomura, Takahisa Goto

    Japanese Journal of Anesthesiology   65 ( 3 )   314 - 317   2016.3

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  • Perioperative considerations in adult mitochondrial disease: A case series and a review of 111 cases Reviewed

    Yuri Miyamoto, Tetsuya Miyashita, Shunsuke Takaki, Takahisa Goto

    MITOCHONDRION   26   26 - 32   2016.1

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    DOI: 10.1016/j.mito.2015.11.004

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  • 肝不全に対するOn-line HDF施行中にバンコマイシン持続投与を行った症例

    堺 結有, 高木 俊介, 金城 梢, 山本 夏啓, 西周 祐美, 出井 真史, 吉田 輔, 山口 嘉一, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   539 - 539   2016.1

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  • 頸部超音波検査により抜管前に食道癌術後の両側反回神経麻痺を診断し得た1例

    山本 夏啓, 山口 嘉一, 堺 結有, 西周 祐美, 吉田 輔, 出井 真史, 高木 俊介, 野村 岳志, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   550 - 550   2016.1

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  • 食道癌術後に冠動脈攣縮による心停止をきたした1症例

    出井 真史, 水谷 健司, 小坂 隆司, 山本 夏啓, 堺 結有, 吉田 輔, 山口 嘉一, 高木 俊介, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   554 - 554   2016.1

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  • HELLP症候群に対する帝王切開術後に右肝梗塞を呈した1例

    西周 祐美, 山口 嘉一, 山本 夏啓, 堺 結有, 出井 真史, 吉田 輔, 高木 俊介, 野村 岳志, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   464 - 464   2016.1

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  • Influence of Mental Workload on the Performance of Anesthesiologists during Induction of General Anesthesia: A Patient Simulator Study Reviewed

    Hitoshi Sato, Tetsuya Miyashita, Hiromasa Kawakami, Yusuke Nagamine, Shunsuke Takaki, Takahisa Goto

    BIOMED RESEARCH INTERNATIONAL   2016   1058750   2016

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  • 食道癌術後に冠動脈攣縮による心停止をきたした1症例

    出井 真史, 水谷 健司, 小坂 隆司, 吉田 輔, 松田 優子, 高木 俊介, 山口 修, 後藤 隆久

    ICUとCCU   39 ( 3 )   187 - 191   2015.3

  • Impalement oral injury: Ultrasonic scalpel is the best tool to cut off a toothbrush Reviewed

    Yoshikazu Yamaguchi, Tetsuya Miyashita, Keiko Toki, Shunsuke Takaki, Takahisa Goto

    TECHNOLOGY AND HEALTH CARE   23 ( 5 )   685 - 690   2015

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    DOI: 10.3233/THC-151013

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  • BLOOD PH IS A USEFUL INDICATOR FOR INITIATION OF THERAPEUTIC HYPOTHERMIA IN THE EARLY PHASE OF RESUSCITATION AFTER COMATOSE CARDIAC ARREST: A RETROSPECTIVE STUDY Reviewed

    Shunsuke Takaki, Yoshinori Kamiya, Yoshio Tahara, Masahumi Tou, Akira Shimoyama, Masayuki Iwashita

    JOURNAL OF EMERGENCY MEDICINE   45 ( 1 )   57 - 63   2013.7

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  • 感染性心内膜炎術後、持続的中心静脈圧高値を認め上大静脈症候群と診断された1症例

    上野 歌奈子, 速水 元, 水谷 健司, 塩田 将, 刈谷 隆之, 高木 俊介, 山口 嘉一, 前島 英恵, 出井 真史, 後藤 隆久

    日本集中治療医学会雑誌   20 ( Suppl. )   374 - 374   2013.1

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  • Nasal high flowが有効であった呼吸不全の一例

    前島 英恵, 速水 元, 水谷 健司, 塩田 将, 高木 俊介, 山口 嘉一, 増淵 哲仁, 出井 真史, 上野 歌奈子, 後藤 隆久

    日本集中治療医学会雑誌   20 ( Suppl. )   405 - 405   2013.1

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  • 敗血症患者に対する遠隔ICUを用いた多職種連携の効果

    高木俊介, 中村謙介, 横瀬真志, 柏木静, 出井真史, 横山暢幸, 佐伯拓也

    Shock   37 ( 1 )   2023

  • A case of head and neck alluminox treatment that can be safely managed by a remote ICU system

    菅沼進也, 出井真史, 竹下朋納, 長岡毅, 横瀬真志, 柏木静, 横山暢幸, 高木俊介

    日本集中治療医学会学術集会(Web)   50th   2023

  • The potential of estimating patient severity by analyzing patients’ live video feeds

    南部雄磨, 田端篤, 青山祥太朗, 辻杏歩, 飯田裕太, 長田光平, 山本浩平, 高木俊介, 南部雄磨, 青山祥太朗, 辻杏歩, 飯田裕太, 長田光平, 山本浩平, 高木俊介

    日本遠隔医療学会雑誌   18   2023

  • Retrospective Observational Study of the Effectiveness of Time Series Scoring in Sepsis

    鈴木崇文, 高木俊介, 出井真史, 水原敬洋, 川内翔一朗, 堂前公希, 伊藤圭亮, 小松田卓也

    日本集中治療医学会学術集会(Web)   50th   2023

  • A behavioral economics approach to encourage measuring respiratory rate in using early warning score

    長岡毅, 高木俊介, 元山文菜, 横瀬真志, 柏木静, 出井真史, 横山暢幸, 原広司, 黒木淳, 佐々木周作

    日本集中治療医学会学術集会(Web)   50th   2023

  • Sepsis due to urinary tract infection complicated by cardiogenic shock by ischemia: a case report.

    酒井洋平, 長嶺祐介, 出井真史, 横山暢幸, 横瀬真志, 柏木静, 高木俊介, 後藤隆久

    日本集中治療医学会学術集会(Web)   50th   2023

  • severe ARDSを発症したVEXAS症候群の一例

    会沢海, 出井真史, 山田菜月, 桝井優, 管沼進也, 横山暢幸, 柏木静, 横瀬真志, 中村謙介, 高木俊介

    Shock   37 ( 1 )   2023

  • 重度の全身性浮腫と敗血症性ショックに対する体液・循環管理を行い良好な転機をたどったTAFRO症候群の一例

    桝井優, 出井真史, 川畑慶一郎, 菅沼進也, 横山暢幸, 柏木静, 横瀬真志, 中村謙介, 高木俊介

    Shock   37 ( 1 )   2023

  • 高流量の血液浄化療法にて救命し得た重症腫瘍崩壊症候群の1例

    辰田功顕, 中村謙介, 会沢海, 桝井優, 出井真史, 横山暢幸, 横瀬真志, 柏木静, 高木俊介

    Shock   37 ( 1 )   2023

  • ICU滞在中のPIICSがPICSに与える影響

    菅沼進也, 中村謙介, 辰田功顕, 川畑慶一郎, 横山暢幸, 柏木静, 出井真史, 東條健太郎, 横瀬真志, 高木俊介

    Shock   37 ( 1 )   2023

  • Monitoring level of consciousness by image analysis: challenges and limitations

    田端篤, 高木俊介, 高木俊介, 南部雄磨, 南部雄磨, 東島紋子, 東島紋子, 辻杏歩, 辻杏歩, 青山祥太朗, 青山祥太朗

    日本遠隔医療学会雑誌   17   2022

  • 目の状態に基づく意識状態モニタリングの現状と課題

    青山祥太朗, 青山祥太朗, 南部雄磨, 南部雄磨, 田端篤, 辻杏歩, 辻杏歩, 高木俊介, 高木俊介

    臨床モニター   33 ( Supplement )   2022

  • Optical flowを用いた体動解析による意識状態モニタリングの課題と可能性

    辻杏歩, 辻杏歩, 南部雄磨, 南部雄磨, 田端篤, 高木俊介, 高木俊介, 青山祥太朗, 青山祥太朗

    臨床モニター   33 ( Supplement )   2022

  • 遠隔ICUの診療報酬化に向けた取り組みと将来展望

    高木俊介, 小松田卓也, 南部雄磨

    日本呼吸療法医学会学術集会プログラム・抄録集   44th (Web)   2022

  • 右内頚静脈より挿入したflexible double-lumen catheter(FDLカテーテル)が胸腔内に迷入し,外科的な抜去術が必要であった一例

    柏木静, 寺田裕作, 横山暢幸, 出井真史, 横瀬真志, 高木俊介

    日本集中治療医学会関東甲信越支部学術集会プログラム・抄録集(Web)   6th   2022

  • Water droplets accumulate in the polyurethane cuff of the tracheal tube after 8 hours: in vitro simulation

    井上真光人, 中澤亮介, 出井真史, 高木俊介, 入江友哉, 後藤隆久

    日本麻酔科学会学術集会(Web)   69th   2022

  • クリティカルケア領域の未来予想図-AIと遠隔ICUと看護の可能性

    高木俊介, 横山暢幸, 出井真史, 柏木静, 横瀬真志, 辻杏歩, 青山祥太朗, 田端篤, 南部雄磨, 藤吉弘亘

    日本クリティカルケア看護学会学術集会抄録集(Web)   18th   2022

  • AIが切り拓く遠隔ICUの将来展望

    高木俊介, 横山暢幸, 出井真史, 柏木静, 横瀬真志, 辻杏歩, 青山祥太朗, 田端篤, 南部雄磨, 藤吉弘亘

    日本集中治療医学会関東甲信越支部学術集会プログラム・抄録集(Web)   6th   2022

  • Overview of the Integration of AI Triage to Watch Over Critically Ill Patients and Tele-ICU

    高木俊介, 南部雄磨, 小松田卓也

    月刊新医療   49 ( 8 )   2022

  • Development of Tele-ICU structure and automated triage system

    高木俊介, 南部雄磨

    月刊Precision Medicine   4 ( 4 )   2021

  • History of Tele-ICU in Japan and prospects for future spread

    高木俊介, 南部雄磨

    医学と薬学   78 ( 7 )   2021

  • 【ポストCOVID-19の集中治療】コロナ禍における遠隔医療の可能性

    高木 俊介, 橋本 悟

    ICUとCCU   44 ( 12 )   745 - 752   2020.12

  • 30年後の救急医療-次世代に向けて 働き方改革における遠隔ICUへの期待 データ利活用型Tele-ICUのシステムについて(厚労科研補助金事業研究班報告)

    高木 俊介, 橋本 悟, 野村 岳志, 土井 研人, 大下 慎一郎, 別府 賢, 秋冨 慎司, 長嶺 祐介, 松村 洋輔, 中西 智之

    日本救急医学会雑誌   30 ( 9 )   540 - 540   2019.9

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  • 当院でのRapid Response System導入後の経過報告

    野垣 文子, 三浦 友也, 稲葉 桜, 高木 俊介, 宮下 徹也, 竹内 一郎

    日本救急医学会雑誌   30 ( 9 )   844 - 844   2019.9

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  • 働き方改革における遠隔ICUへの期待 Tel-ICUの法的検証について(厚労科研補助金事業研究班報告)

    中西 智之, 高木 俊介, 橋本 悟, 野村 岳志, 土井 研人, 別府 賢, 大下 慎一郎, 長嶺 祐介, 秋冨 慎司, 松村 洋輔

    日本救急医学会雑誌   30 ( 9 )   835 - 835   2019.9

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  • 働き方改革における遠隔ICUへの期待 Tel-ICUの法的検証について(厚労科研補助金事業研究班報告)

    中西 智之, 高木 俊介, 橋本 悟, 野村 岳志, 土井 研人, 別府 賢, 大下 慎一郎, 長嶺 祐介, 秋冨 慎司, 松村 洋輔

    日本救急医学会雑誌   30 ( 9 )   835 - 835   2019.9

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  • 30年後の救急医療-次世代に向けて 働き方改革における遠隔ICUへの期待 データ利活用型Tele-ICUのシステムについて(厚労科研補助金事業研究班報告)

    高木 俊介, 橋本 悟, 野村 岳志, 土井 研人, 大下 慎一郎, 別府 賢, 秋冨 慎司, 長嶺 祐介, 松村 洋輔, 中西 智之

    日本救急医学会雑誌   30 ( 9 )   540 - 540   2019.9

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  • 働き方改革における遠隔ICUへの期待 労務軽減と医療の質向上(厚労科研補助金事業 研究班報告)

    松村 洋輔, 高木 俊介, 土井 研人, 大下 慎一郎, 長嶺 祐介, 橋本 悟

    日本救急医学会雑誌   30 ( 9 )   693 - 693   2019.9

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  • 当院でのRapid Response System導入の経緯と現状

    野垣 文子, 三浦 友也, 高木 俊介, 宮下 徹也, 竹内 一郎

    日本臨床救急医学会雑誌   22 ( 2 )   398 - 398   2019.4

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  • 妊娠による循環血漿量増加で顕在化した肺水腫に対し、多職種による集学的治療が功を奏した左房腫瘍の一例

    桑原 香折, 菅原 陽, 安西 晃子, 辻 匠子, 横山 暢幸, 濱田 貴子, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [P33 - 2]   2019.2

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  • Vascular slingに先天性気管狭窄症を合併し呼吸管理に難渋した一例

    濱田 貴子, 菅原 陽, 桑原 香折, 安西 晃子, 横山 暢幸, 辻 匠子, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [P4 - 2]   2019.2

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  • 集中治療室入室患者に対する天井設置型マイクロ波ドップラーセンサによる呼吸回数測定の正確性の検討

    田中 宏幸, 横瀬 真志, 安西 晃子, 桑原 香折, 辻 匠子, 濱田 貴子, 柏木 静, 菅原 陽, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [O63 - 1]   2019.2

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  • 血球貪食症候群および真菌感染による低酸素血症に対しECMOを用いた集学的治療により救命しえた小児の一例

    辻 匠子, 菅原 陽, 高木 俊介, 桑原 香折, 安西 晃子, 濱田 貴子, 横山 暢幸, 柏木 静, 横瀬 真志, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [P69 - 3]   2019.2

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  • PI値はClearSightによる心拍出量測定の正確性の指標となるか?

    横瀬 真志, 早川 翔, 田中 宏幸, 濱田 貴子, 吉田 輔, 高木 俊介, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   25 ( Suppl. )   [O72 - 5]   2018.2

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  • 胸筋神経ブロックの局所麻酔薬の広がりについての献体を用いた検討

    菊池 賢, 高木 俊介, 野村 岳志

    麻酔   65 ( 3 )   314 - 317   2016.3

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    Other Link: http://search.jamas.or.jp/link/ui/2016344183

  • 炎症反応が亢進した周術期において,高張アルブミンと晶質液が全拡張周期容量や肺血管外水分量に与える影響について

    高木俊介, 山本夏啓, 堺結有, 西周祐美, 吉田輔, 出井真史, 山口嘉一, 野村岳志, 山口修, 後藤隆久

    日本呼吸療法医学会学術集会プログラム・抄録集   38th   2016

  • 皮膚筋炎に伴う間質性肺炎に縦隔気腫を合併し,ECMOを要した一例

    松田優子, 山本夏啓, 出井真史, 吉田輔, 山口嘉一, 高木俊介, 山口修, 後藤隆久

    日本呼吸療法医学会学術集会プログラム・抄録集   38th   2016

  • 小児心臓外科術後におけるHigh‐flow nasal cannula(HFNC)の有用性

    出井真史, 宮下徹也, 山本夏啓, 堺結有, 吉田輔, 松田優子, 山口嘉一, 高木俊介, 野村岳志, 山口修, 後藤隆久

    日本呼吸療法医学会学術総会プログラム・抄録集   38th   272   2016

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  • Effects of Breathing Pattern on Oxygen Delivery Via a Nasal or Pharyngeal Cannula

    Natsuhiro Yamamoto, Tetsuya Miyashita, Shunsuke Takaki, Takahisa Goto

    RESPIRATORY CARE   60 ( 12 )   1804 - 1809   2015.12

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  • Perioperative change in creatinine following cardiac surgery with cardiopulmonary bypass is useful in predicting acute kidney injury: a single-centre retrospective cohort study

    Shunsuke Takaki, Yahya Shehabi, John W. Pickering, Zoltan Endre, Tetsuya Miyashita, Takahisa Goto

    INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY   21 ( 4 )   465 - 469   2015.10

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  • Evaluation of an Oxygen Mask-Based Capnometry Device in Subjects Extubated After Abdominal Surgery

    Shunsuke Takaki, Takahiro Mihara, Kenji Mizutani, Osamu Yamaguchi, Takahisa Goto

    RESPIRATORY CARE   60 ( 5 )   705 - 710   2015.5

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  • Modified rapid shallow breathing index adjusted with anthropometric parameters increases predictive power for extubation failure compared with the unmodified index in postcardiac surgery patients

    Shunsuke Takaki, Suhaini Bin Kadiman, Sharifah Suraya Tahir, M Hassan Ariff, Kiyoyasu Kurahashi, Takahisa Goto

    Journal of Cardiothoracic and Vascular Anesthesia   29 ( 1 )   64 - 68   2015.2

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    DOI: 10.1053/j.jvca.2014.06.022

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  • Self-inflicted oral penetration injury: An intravenous drip pole advanced from the mouth to the retroperitoneum

    Shunsuke Takaki, Osamu Yamaguchi, Naoto Morimura, Takahisa Goto

    International Journal of Surgery Case Reports   16   112 - 1125   2015

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    DOI: 10.1016/j.ijscr.2015.09.019

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  • Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

    Tomoki Doi, Tetsuya Miyashita, Ryousuke Furuya, Hitoshi Sato, Shunsuke Takaki, Takahisa Goto

    BIOMED RESEARCH INTERNATIONAL   2015   2015

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  • 麻酔器・人工呼吸器によるVCV・DCVの新生児呼吸器モデルへの適用―シミュレーション研究―

    山口嘉一, 宮下徹也, 佐々木誠, 松田優子, 高木俊介, 塩田将, 水谷健司, 山口修, 後藤隆久

    日本集中治療医学会学術集会(Web)   42nd   DP109-3 (WEB ONLY)   2015

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  • 腫瘍摘出後に重篤な循環不全を呈した巨大褐色細胞腫の一例

    長嶺 祐介, 西成田 玲子, 倉橋 清泰, 上野 歌奈子, 前島 英恵, 高木 俊介, 塩田 将, 水谷 健司, 速水 元, 後藤 隆久

    日本集中治療医学会雑誌   20 ( Suppl. )   426 - 426   2013.1

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  • 気管に誤挿入された胃管が気管チューブ先端からチューブ内腔に迷入し、抜去困難になった1症例

    高木 俊介, 鈴木 麻衣子, 渡辺 裕生, 倉橋 清泰

    麻酔   57 ( 1 )   119 - 119   2008.1

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Presentations

  • Predictors of postoperative hyperglycemia after pediatric cardiac surgery A single centre retrospective cohort study. International conference

    Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Nomura Takeshi, Osamu Yamaguchi, Takahisa Goto

    Euro anesthesia  2016.5 

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  • A case report: Continuous administration of vancomycin during on-line hemodiafiltration in the hepatic failure patient with staphylococcus bacteremia International conference

    Yu Sakai, Shunsuke Takaki, Takeshi Nomura, Osamu Yamaguchi, Takahisa Goto

    Euro anesthesia  2016.5 

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  • Low hematocrit on ICU admission is a risk factor of long term outcome in patients who required prolonged mechanical ventilation after cardiovascular surgery. A single center retrospective cohort study International conference

    Akito Tsukinaga, Shunsuke Takaki, Takahiro Mihara, Masahide Ohtsuka, Takahisa Goto, Kiyoyasu Kurahashi

    Euro anesthesia  2016.5 

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  • Dimethyloxalylglycine, a prolyl hydroxylase inhibitor,attenuates Fas ligand-0induced apoptosis and lung injury in mice

    Yusuke Nagamine, Kentaro Tojo, Takuya Yazawa, Shunsuke Takaki, Yasuko Baba, Takahisa Goto, Kiyoyasu Kurahashi

    2016 

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  • Creatinine reduction ratio is a good prognostic factor of perioperative acute kidney injury and long-term renal function after cardiac surgery with cardiopulmonary bypass. A single centre retrospective cohort study International conference

    Akiko Anzai, Shunsuke Takaki, Yuri Miyamoto, Tomoya Irie, Osamu Yamaguchi, Takahisa Goto

    Euro anesthesia  2016.5 

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  • Oxygen deliverly for patients undergoing upper gastrointestinal endoscopy: a mannequin study International conference

    Yamamoto N, Miyashita T, Takaki, S. Goto T

    Euro anesthesia  2015.6 

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  • Evaluation of an oxygen nasal cannula-based capnometry device for respiratory monitoring in patients extubated after abdominal surgery : A prospective observational study International conference

    Fukuchi M, Takaki S, Yamaguchi O, Goto T

    Euro anesthesia  2015.5 

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  • The effect of hypertonic albumin administration on extra vascular lung water and global end-diastolic volume - Prospective observational study - International conference

    Yoshida T, Takaki S, Yamaguchi O, Goto T

    Euro anesthesia  2015.6 

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  • Creatinine reduction ratio (CCR) is useful for excluding AKI after cardiac surgery: a preliminary retrospective study International conference

    Takaki S, Shehabi Y, Peake P, Pickering J, Zoltan E, Goto T

    Euro anesthesia  2014.6 

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  • Prophylactic minitracheostomy affect early to mid term mortality in cardiac patients who are at risk of respiratory dysfunction International conference

    Yamamoto Shoko, Takaki, S. Idei, M. Mizutani, K. Yamaguchi, O. Goto T

    Euro anesthesia  2015.5 

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  • Prospective observational study: the most useful parameter for predicting extubation failure in patients extubated within 48 h after cardiac surgery- RSBI should be adjusted for actual body weight. International conference

    Takaki S. Suhaini, K, Sarifah T, Hassan A

    Euro anesthesia  2012.6 

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  • Evaluation of a new mask-based capnometry device for continuous monitoring of carbon dioxide during different breathing patterns in patients extubated after abdominal surgery: A prospective observational study International conference

    Takaki S, Mihara T, Mizutani K, Yamaguchi O, Goto T

    Euro anesthesia  2013.5 

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  • A prospective crossover study for assessment of Global End-Diastolic Index to compare of albumin administration compared to crystalloid in the perioperative inflammatory status. International conference

    Yumi Saishu, Shunsuke Takaki, Tasuku Yoshida, Takeshi Nomura, Osamu Yamaguchi, Takahisa Goto

    Euro anesthesia  2016.5 

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Research Projects

  • Cell-free RNAを用いた全身の細胞の状態を反映した多臓器障害サブフェノタイピング

    Grant number:24K12137  2024.4 - 2027.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    菅原 陽, 川上 英良, 中村 謙介, 東條 健太郎, 高木 俊介

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    Grant amount:\4550000 ( Direct Cost: \3500000 、 Indirect Cost:\1050000 )

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  • 大侵襲手術後PIICSの実態解明と予防的治療標的同定のための病態解析

    Grant number:24K02539  2024.4 - 2027.3

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    後藤 隆久, 水原 敬洋, 杉浦 悠毅, 中村 謙介, 東條 健太郎, 高木 俊介

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    Grant amount:\18590000 ( Direct Cost: \14300000 、 Indirect Cost:\4290000 )

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  • 好中球の包括的な免疫代謝解析に立脚した好中球機能の回復による敗血症治療法の開発

    Grant number:22K09146  2022.4 - 2025.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    東條 健太郎, 杉浦 悠毅, 高木 俊介

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    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    本研究では,免疫系細胞が代謝パターンの変化を介して細胞機能を制御していることがわかってきたことを踏まえ,好中球が様々なエフェクター機能を行使するのにあたり,どのような制御機構で,どのように代謝パターンを変化させているのか解析し,敗血症における代謝機能障害を明らかにした上で,敗血症の治療標的を同定することが目的である。
    2022年度には,ラット好中球を用いて遊走因子であるf-MLP,活性化因子であるPMA刺激時の代謝パターンの変化について代謝フラックスアナライザーを用いて解析をした。f-MLP刺激では,解糖系の指標であるExtracellular Acidification Rate(ECAR)の増加が見られた一方で,PMA刺激時にはECARに加えてOxygen Consumption Rate(OCR)の著名な増加が見られた。このOCRの増加はミトコンドリアではなく,ペントースリン酸経路からNADPHオキシダーゼを介した呼吸バーストに伴う変化だと考えられた。上記から,好中球の遊走時と活性化時には異なる代謝パターンが観察されることが示唆された。
    上記の結果を踏まえ,今後いくつかの好中球に対する刺激因子を組み合わせる,あるいは段階的に刺激をすることによって,遊走,呼吸バースト,脱顆粒,Neutrophil Extracellular Trapsの形成などのエフェクター機能毎に,どのような代謝パターンを示すのか,さらなる検討を行ない,機能毎にキーとなる代謝経路の同定を進める予定である。

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  • 肺胞上皮細胞の自然免疫応答を標的とした院内肺炎予防法開発に向けた基盤研究

    Grant number:21K09027  2021.4 - 2024.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    柏木 静, 東條 健太郎, 高木 俊介

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    Grant amount:\4030000 ( Direct Cost: \3100000 、 Indirect Cost:\930000 )

    本研究の目的は,一度,肺炎等によって肺で炎症が生じた後の肺胞上皮細胞の自然免疫応答の変化について,その背景にある分子機構を明らかにし,免疫応答を正常化させることで院内二次肺炎の新規予防法の開発につなげることである。2021年度にはマウスにリポポリサッカライド(LPS)を気管内投与することによって肺に炎症を起こしてから,炎症が治まってくる1週間後に再度LPSやバクテリア等の病原体の気管内投与を行った際の自然免疫応答について解析を開始した。また,傷害をうけた肺の局所の自然免疫応答について,肺胞上皮細胞を含む種々の細胞の種類毎に解析を行うためにシングルセル懸濁液の作成及び細胞単離法について検討を行った。
    LPSを気管内投与後,1週間が経過したタイミングにおいて,再度LPSの気管内投与を行ったところ,肺への好中球遊走の低下が認められ,さらに気管支肺胞洗浄液中のケモカインの量が低下していた。以上から,肺傷害を受けた後にしばらくの間,肺局所の自然免疫応答が低下しており,二次性肺炎が重症化しやすい状態となっていることが示唆された。一方で,マウスの肺組織からのシングルセル懸濁液および細胞単離においては,まず健常なマウスを用いてコラゲナーゼを用いた細胞の分離,懸濁を行ったが,フローサイトメトリーでの解析の結果,上皮細胞系のマーカーである上皮細胞接着因子(EPCAM)陽性となる細胞分画が少なく,全ての細胞を充分に含む細胞懸濁液の作成ができていないことから,別の方法での作成が必要であると考えられた。

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  • 敗血症におけるインスリン抵抗性の生物学的意義の解析と治療応用に向けた基盤研究

    Grant number:21K09053  2021.4 - 2024.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    太田 周平, 東條 健太郎, 高木 俊介

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    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    本研究の目的は,敗血症におけるインスリンシグナルの変化およびそれに対する制御が,敗血症の病態に与える影響を検討することで,その生物学的意義を明らかにし,インスリンシグナル経路およびその下流の代謝変化を標的とした新規治療法の開発につなげることである。2021年度にはマウスの盲腸結紮穿刺(CLP)敗血症モデルを用いて,グルコース代謝の変化を解析するとともに,Insulin Receptor Substrate(IRS)-1,及び-2のノックアウトマウスの安定した繁殖を目指して研究を行った。
    マウスのCLP敗血症モデルにおいては,コントロールであるsham手術マウスと比較して,24時間後の段階で血糖値が低下する傾向があることを確かめることができた。腹腔内投与によるグルコース負荷試験およびグルコース+インスリン負荷試験をおこなったところ,グルコース負荷試験においてCLPマウスにおいては血糖値の低下がsham手術マウスよりも早い傾向が認められた。さらに,sham手術マウスではグルコースと同時にインスリンを投与することで,血糖値の増加が抑制できた一方,CLPマウスにおいてはグルコースのみの投与と比較して明らかな変化が見られなかったこと。これらを総合すると,CLPマウスにおいてはインスリン非依存性,依存性それぞれのグルコース代謝に異なる特徴的な変化が見られることが示唆された。
    また,IRS-1,-2のノックアウトマウスについては安定した繁殖にやや時間を要したが,2021年度末には十分な繁殖を行うことができてきている。

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  • 人工知能を用いた鎮静及び鎮痛スケールの予測モデルの構築

    Grant number:18K08896  2018.4 - 2023.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    横瀬 真志, 高木 俊介

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    Grant amount:\4420000 ( Direct Cost: \3400000 、 Indirect Cost:\1020000 )

    我々はネットワークにより医療情報を集約化した遠隔集中治療室(Tele-ICU)の構築を介して医療従事者の負担軽減や医療の質の向上を目標としている。その中の一つの機能として本研究の目指す鎮静・鎮痛スケールの予測モデルを持つ人工知能の開発がある。天井設置型カメラから得られた患者の表情画像をデータベース化し、同時刻の鎮静・鎮痛状態を評価する各種スケールとバイタルサイン(血圧、心拍数、 酸素飽和度、呼吸回数、体温)とを突合して機械学習を行う。年度毎に収集されるデータを用いて、正答率を高めて臨床応用に耐えうるモデル作成を目的としている。
    初年度ではICU患者の特性上酸素マスクや点滴ライン等の人工物が対象者の顔の付近に多く、その状況下でも対象者の顔パーツを認識可能なモデル作成の必要性を明らかとした。2年目は、顔、及び眼にフォーカスして、人工物存在下でのそれらパーツの認識正答率を複数の機械学習・物体検知モデルを用いて性能の比較を行った。最も高性能であったモデルでも画像中において非常に小さな物体となる眼の検出精度が50%程度と課題が残った。一昨年度はモデル精度向上のための学習用データ収集を目標とした。並行してAVPUスコア[Alert(意識清明)Verbal(声かけに反応) Pain(疼痛刺激に反応) Unresponsive(反応なし)]のうち、AとVPUとの2つの群を判別するモデルの作成を目標とした。COVID-19パンデミックの影響から症例数が減少し、研究の遅れを招いた。昨年度はこれまでと同様に、眼の物体検出性能の向上、並びに前述のAVPUスコアをAとVPUの2群に分類して評価できるモデルの作成を行なった。

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  • Automated Prediction model with machine learning

    2017.6 - 2018.3

    Ministry of internal affairs and communications  Strategic Information and Communications R&D Promotion Programme 

    TAKAKI Shunsuke

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    Authorship:Principal investigator  Grant type:Competitive

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  • The protective effects of activation of HIF on alveolar epithelial cells

    Grant number:25861392  2013.4 - 2016.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Young Scientists (B)

    TAKAKI Shunsuke

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    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    We investigated the effect of stabilization of HIF-1α by treatment with dimethyloxalylglycine (DMOG); a prolyl hydroxylase inhibitor on FasL-induced alveolar epithelial apoptosis in vitro and in vivo. DMOG increased HIF-1α protein levels in MLE12 cells, and attenuated FasL-induced caspase activation and cell death. Inhibition of HIF-1 pathway by echinomycin; an inhibitor of HIF-1 binding to DNA, or by siRNA transfection abolished the anti-apoptotic effect of DMOG. Intraperitoneal administration of DMOG also suppressed apoptosis in lung tissues in the mice intratracheally instilled with FasL. Moreover, DMOG attenuated disruption of alveolar barrier and histological changes in these mice. Prolyl hydroxylase inhibition protects lung epithelial cells from FasL-induced apoptosis and attenuated the lung injury.

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