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Affiliation |
Graduate School of Medicine Doctorial Course in Medicine Bioregulatory Medicine Department of Emergency and Critical Care Medicine |
OKUYAMA Manabu
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Graduating School 【 display / non-display 】
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-1995.03
Akita University Faculty of Medicine Graduated
Campus Career 【 display / non-display 】
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2018.09-Now
Akita University Graduate School of Medicine Doctorial Course in Medicine Bioregulatory Medicine Associate Professor
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2016.09-2018.08
Akita University Graduate School of Medicine Doctorial Course in Medicine Bioregulatory Medicine Lecturer
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2013.04-2016.08
Akita University Hospital Intensive Care Unit Assistant Professor
Thesis for a degree 【 display / non-display 】
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Soluble and cell-associated forms of some yet to be identified factor in transfused blood which promotes solid tumor growth in mice.
Motoyama S, Saito S, Saito R, Nakamura M, Imano H, Minamiya Y, Ogawa J
Surger Today 34 ( 8 ) 673 - 677 2003.03
Domestic Co-author
Research Achievements 【 display / non-display 】
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Association Between the Simplest Clinical Factors and Emergency Department Dispositions: A Retrospective Observational Study.
Kasumi Satoh, Manabu Okuyama, Hajime Nakae
Cureus 13 ( 1 ) e12844 2021.01
Research paper (journal)
The emergency department (ED) is a complex and busy environment that requires rapid decision making. We assessed the relationship between disposition from the ED and information that can be obtained at a glance in the ED. The presentation of the implications of commonplace information could assist healthcare providers in ensuring smooth and safe ED care. Thus, we aimed to quantitatively assess how readily obtainable findings, such as age, sex, and vital signs, are involved in the disposition of adult patients transferred to the ED. This retrospective observational study was conducted in the ED of a regional university hospital containing approximately 600 beds. Of the 685 patients included in the analysis, 351 patients were admitted to the hospital (including 12 deaths in the ED) and 334 patients were discharged from the ED. A multiple logistic regression model that included age, sex, systolic blood pressure, heart rate, respiration rate, temperature, and SpO2 as variables identified independent associations between age (p=0.003), sex (p<0.001), systolic blood pressure (p=0.023), heart rate (p<0.001), and respiratory rate (p=0.028) and admission from the ED. The receiver operating characteristic curves drawn from the multiple logistic regression model comprising these five variables had an area under the curve (AUC) of 0.701 (95% confidence interval: 0.657-0.744, p<0.001). Examination of sensitivity, specificity, and likelihood ratios (LRs) for these five variables for clinical utility showed a slightly higher sensitivity for age ≥50 years (0.849) and respiratory rate ≥18 bpm (0.769); higher specificity for systolic blood pressure ≤100 mmHg (0.938), pulse rate ≥100 bpm (0.834), and respiratory rate ≥26 bpm (0.887); higher positive LR for systolic blood pressure ≤100 mmHg (2.039) and pulse rate ≥110 bpm (2.729); and slightly lower negative LR for age ≥50 years (0.656), male sex (0.647), respiratory rate ≥20 bpm (0.669). These results are meaningful as they quantify the intuition of a skilled clinician, which can help in clinical decision making, reduce errors, and promote clinical education. Our study provides a basis for explaining to novice healthcare providers that the careful observation of ED patients, even in the absence of special laboratory tests, can help them to make judgments regarding the disposition of the patients from the ED. In conclusion, age, sex, systolic blood pressure, heart rate, and respiratory rate were independently associated with a disposition from the ED. A multivariate model including these five variables showed the moderate-quality potential to predict admission from the ED. The sensitivity, specificity, and LR of systolic blood pressure, heart rate, and respiratory rate showed the characteristics of each vital sign. These provide healthcare providers in the ED an immediate clue regarding the patient's illness.
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The impact of organ dysfunctions on mortality in patients with severe sepsis: A multicenter prospective observational study.
Kudo D, Kushimoto S, Miyagawa N, Sato T, Hasegawa M, Ito F, Yamanouchi S, Honda H, Andoh K, Furukawa H, Yamada Y, Tsujimoto Y, Okuyama M.
Journal of Critical Care 2018.01 [Refereed]
Research paper (journal) Domestic Co-author
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Comparison of quality of human serum albumin preparations in two pharmaceutical products.
Nakae H, Tomida K, Kikuya Y, Okuyama M, Igarashi T
Acute Medicine & Surgery 2017.07 [Refereed]
Research paper (journal) Domestic Co-author
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Fire evacuation drill as disaster management training: A focus on command, safety, communication, and assessment
Manabu Okuyama, Satoru Motoyama, Toshiko Igarashi, Hajime Nakae
2017.07 [Refereed]
Research paper (journal) Domestic Co-author
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Retrospective study on efficacy and safety of Jidabokuippo in real-world clinical practice
Nakae Hajime, Kitamura Toshiharu, Satoh Kasumi, Hirasawa Nobuhisa, Kameyama Koumei, Nara Tasuku, Suzuki Yuya, Yoshida Kenji, Maeno Kyohei, Tsuchida Hideomi, Yasuda Takuto, Saruta Rio, Okuyama Manabu
Personalized Medicine Universe ( 一般社団法人 国際個別化医療学会 ) 13 ( 0 ) 38 - 45 2024.11
<p>Purpose: Few studies have investigated the treatment outcomes and adverse events after using jidabokuippo (JDI), including the concomitant use of Kampo prescriptions and analgesics. In this study, we retrospectively analyzed the efficacy and safety of JDI in real-world clinical practice.</p><p>Methods: The study included 306 patients who were treated with JDI. Treatment outcomes and adverse events were compared according to age, sex, presence or absence of comorbidities, concomitant use of Kampo prescriptions and analgesics, daily dose of JDI, duration of administration, and the starting time of administration. The patients were divided into two groups: effective and ineffective.</p><p>Results: Concomitant use of Kampo prescriptions and analgesics was observed in 14.1% and 58.2% of the patients, respectively. The efficacy rate of JDI was 97.7%. The duration of JDI treatment in the analgesic group was significantly longer than that in the non-analgesic group (<i>p</i> = 0.0100). None of the patients reported any adverse events.</p><p>Conclusion: The efficacy rate of JDI was as high as 97.7% and no adverse events were observed. Adverse events can be prevented by being cautious of the side effects of Kampo prescriptions. However, the rate of concomitant use of analgesics was high, and the effects of reducing the dosage and frequency of analgesics remains to be determined.</p>
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Hyperthyroidism With Non-chylous Ascites: A Case Report.
Shodai Takahashi, Kasumi Satoh, Manabu Okuyama, Nobuhisa Hirasawa, Hajime Nakae
Cureus 15 ( 10 ) e46657 2023.10
Ascites is the accumulation of fluid in the abdominal cavity and is commonly attributed to various etiologies, including portal hypertension and peritoneal diseases. Hyperthyroidism is rarely associated with ascites, which is typically chylous and accompanied by high central venous pressure. We present a unique case of a 57-year-old woman with untreated hyperthyroidism who manifested non-chylous ascites without evidence of high venous pressure. Initially presenting with left lower leg pain, the patient presented with leg edema, abdominal distention, and diarrhea. A range of diagnostic tests ruled out common etiologies of ascites, such as liver cirrhosis, renal impairment, heart failure, infection, and malignancy. Ascites was characterized by low triglyceride levels, while no evidence of high venous pressure was found. Notably, the patient showed decreased levels of rapid turnover proteins, suggesting hypercatabolism and insufficient protein synthesis due to hyperthyroidism. Upon the initiation of antithyroid therapy, the patient's symptoms markedly improved. In conclusion, this report highlights a rare manifestation of hyperthyroidism that resulted in non-chylous ascites without high venous pressure. This underscores the need to include hyperthyroidism in the differential diagnosis of unexplained ascites, particularly in cases in which classical hyperthyroid symptoms are absent.
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Chest Pain Diagnosed as Acute Leukemia: Focus on Coagulation Abnormalities Rather Than White Blood Cell Count.
Kyohei Maeno, Kasumi Satoh, Nobuhisa Hirasawa, Manabu Okuyama, Hajime Nakae
Cureus 15 ( 3 ) e35992 2023.03
Chest pain is an important symptom for emergency physicians. It is one of the most common causes for admission in emergency departments. Acute leukemia (AL) rarely causes chest symptoms due to ostalgia, and it is difficult to diagnose leukemia as the cause of chest pain. An 83-year-old woman with no history of trauma presented to the emergency department with a one-day history of severe chest pain. There were no abnormalities on electrocardiography, echocardiography, specific biomarkers for cardiac injury, or contrast computed tomography of the chest and pelvis. The white blood cell count was normal, but the patient had prominent thrombocytopenia with platelets of 68,000/µL, prothrombin time-international normalized ratio (PT-INR) of 1.2, activated partial thromboplastin time (APTT) of 25.3 s, and D-dimer of 73.55 µg/mL. Due to the holiday, blast cells could not be measured on the same day. The next day's examination revealed blast cells in the peripheral blood. The patient was admitted to the hematology department and discharged three months later. This case suggests the need to consider AL in chest pain associated with coagulation abnormalities and thrombocytopenia, regardless of the white blood cell count.
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Severe Drug-Induced Liver Injury From Over-the-Counter Medication.
Kasumi Satoh, Manabu Okuyama, Nobuhisa Hirasawa, Hajime Nakae
Cureus 15 ( 1 ) e33558 2023.01
Drug-induced liver injury (DILI) is difficult to diagnose as it presents with a wide variety of clinical manifestations and there is no established specific biomarker. However, clinicians require expertise in diagnosing DILI as it can lead to critical illness, is relatively common, and can be caused by a variety of drugs, herbal medicines, and supplements. A 67-year-old male was admitted to the hospital with a fever, jaundice, and fatigue. Abdominal ultrasonography, computed tomography, and magnetic resonance cholangiopancreatography revealed no morphological abnormalities in the hepatobiliary system. On the third day of hospitalization, the liver damage and acute kidney injury progressed, and the patient was transferred to our intensive care unit. To further investigate the cause of multiple organ damage, the patient underwent repeated history taking and additional laboratory testing. In addition to the common causes of hepatic and renal damage, we also tested for rickettsiosis and leptospirosis, as the patient reported partaking regularly in outdoor leisure activities. On day seven of hospitalization, the patient recalled taking over-the-counter herbal flu medications approximately five days prior to admission; therefore, we suspected DILI and performed a drug-induced lymphocyte stimulation test (DLST). The DLST was positive for one drug. As other causes had been ruled out, the patient was diagnosed with severe DILI. The clinical course of the patient was observed with the patient's laboratory data and fever improving spontaneously. This case taught us several important lessons for the investigation of liver injury. Firstly, even with over-the-counter drugs, liver injury can be severe. Secondly, while the DLST is available for investigating DILI, false positives, especially for medicinal herbs, should be noted, and it is necessary to adequately rule out other diseases. Finally, when the cause of liver injury is unclear, patient history taking should be repeated carefully.
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Severe acute respiratory distress syndrome caused by Otsujito.
Nobuhisa Hirasawa, Hajime Nakae, Kasumi Satoh, Kenji Yoshida, Manabu Okuyama
Acute medicine & surgery 10 ( 1 ) e874 2023
BACKGROUND: Kampo prescriptions can cause drug-induced lung injury (DLI) and acute respiratory distress syndrome (ARDS). However, severe respiratory failure induced by Otsujito (OJT) is extremely rare. High-dose steroid pulse therapy is generally given to patients with severe DLI. CASE PRESENTATION: A 63-year-old man with respiratory distress was admitted to our hospital. The patient was diagnosed with severe ARDS caused by OJT, which had been prescribed 4 weeks prior to admission. Thus, OJT was discontinued, and intensive care for ARDS, including ventilation and prone positioning, was implemented. His respiratory condition rapidly improved after treatment with an initial methylprednisolone dose (1.5 mg/kg/day). He was extubated on day 4 and discharged on day 16. The steroid dose was gradually reduced and discontinued by day 116. CONCLUSION: A severe case of ARDS caused by OJT was successfully treated with low-dose steroids and specialized intensive care.
◆Original paper【 display / non-display 】
◆Other【 display / non-display 】
Grant-in-Aid for Scientific Research 【 display / non-display 】
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Grant-in-Aid for Scientific Research(C)
Project Year： 2005.04 - 2007.03