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平澤 暢史 (ヒラサワ ノブヒサ)
HIRASAWA Nobuhisa
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Characteristics of black bear‐related trauma: A retrospective observational study
Hideomi Tsuchida, Kasumi Satoh, Nobuhisa Hirasawa, Manabu Okuyama, Hajime Nakae
Acute Medicine & Surgery ( Wiley ) 11 ( 1 ) 2024年01月
研究論文（学術雑誌）
Abstract
Aim
Bear‐related trauma is a significant concern in Japan. This study identified trauma patterns, outcomes, and therapeutic approaches for bear‐related injuries treated.
Methods
This retrospective observational study used medical records from Akita University Hospital, focusing on patients with bear‐related trauma in 2023. Demographic data, injury details, treatment procedures, and outcomes were extracted.
Results
The study included 20 patients (median age: 74.5 years, 65% males). Most injuries occurred in human habitats, mainly in autumn, with the face being the most affected area (90%). Three patients required emergency transfusions and tracheal intubation. Emergency surgery was performed in 52.6% of patients, and 42.1% were admitted to the intensive care unit. All patients survived with a median hospital stay of 17 days. However, 15.8% of patients had significant sequelae, such as blindness. Despite prophylactic antibiotics, wound infections occurred in 21.1% of patients, particularly in deep wounds that were not adequately washed under general anesthesia.
Conclusions
Bear‐related trauma often results in severe upper‐body injuries that require prompt medical intervention. These findings highlight the need for improved preventive measures and strategies for initial treatment and long‐term care. -
Takuto Yasuda, Kasumi Satoh, Nobuhisa Hirasawa, Manabu Okuyama, Hajime Nakae
Acute Medicine & Surgery ( Wiley ) 11 ( 1 ) 2024年01月
研究論文（学術雑誌）
Abstract
Background
Direct reinfusion of pericardial blood during cardiac surgery triggers a systemic inflammatory response. Although various inflammatory mediators have been identified as triggers, the role of damage‐associated molecular patterns (DAMPs) remains poorly understood. Despite guidelines recommending against this practice owing to its harmful effects, it is sometimes used in emergencies.
Case Presentation
A 72‐year‐old man with atrial fibrillation and cerebral infarction developed cardiac tamponade during catheter ablation. He underwent pericardial drainage and direct blood reinfusion. He was transferred to our ICU, where he developed acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). Despite aggressive management, the patient died 41 days after admission.
Conclusion
This case highlights severe adverse events following direct reinfusion of pericardial blood. These findings suggest a significant role for DAMPs in mediating these inflammatory responses. Direct reinfusion of pericardial drainage blood should be avoided during emergencies to prevent life‐threatening complications. -
Suzuki Y.
Therapeutic Apheresis and Dialysis ( Therapeutic Apheresis and Dialysis ) 27 ( 6 ) 1028 - 1034 2023年12月 [査読有り]
研究論文（学術雑誌）
INTRODUCTION: Coronavirus disease 2019 (COVID-19) is associated with a marked increase in the inflammatory cytokines, IL-6 and IL-18. Blood purification therapy aimed at controlling cytokines is one treatment option; however, evidence of its effectiveness is needed. Plasma exchange with dialysis (PED) is a blood purification method involving selective plasma exchange with dialysate flowing through the outer hollow fiber of the plasma separator. In this retrospective study, we investigated the efficacy of continuous PED (cPED) over 48 h in five patients with severe COVID-19. METHODS: We assessed changes in IL-6 and IL-18, as well as adiponectin (APN). RESULTS: There were no significant differences in changes in IL-6 and IL-18, but there was a marked improvement in cases with abnormally high IL-6 and IL-18 levels at baseline. APN, which inhibits inflammatory cytokines, was significantly elevated post-cPED. CONCLUSION: Our results suggest that cPED therapy is an effective treatment for COVID-19.
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Makyoyokukanto use in patients with painful afflictions
Hirasawa Nobuhisa, Nakae Hajime, Tanaka Hidenori, Irie Yasuhito
Personalized Medicine Universe ( 一般社団法人 国際個別化医療学会 ) 12 ( 0 ) 16 - 22 2023年11月 [査読有り]
研究論文（学術雑誌）
<p>Aim: Makyoyokukanto (MKYK) is a traditional Japanese medicine used for relieving arthralgia, neuralgia, and myalgia. However, the effectiveness and safety of MKYK remains unclear. In this study, we assessed the effectiveness of MKYK in patients with painful afflictions.</p><p>Methods: One hundred and sixty-three patients (42 men and 121 women) with painful afflictions were recruited into the study. All participants were treated using non-invasive methods and administered MKYK. The effectiveness of MKYK was assessed following administration by evaluating the need for NSAIDs or other medication. In addition, adverse reactions were monitored.</p><p>Results: 85.9% of the patients were effectively treated with MKYK. Comorbidities were present in 52.8% of the study participants. The median duration of MKYK treatment was 14 days (2–364 days). The adverse event rate was 1.2%. The adverse events were insomnia caused by Ephedra herb and pseudoaldosteronism by Glycyrrhiza root. All symptoms improved after MKYK withdrawal.</p><p>Conclusion: The adverse event rate associated with MKYK use was low, and its onset was relatively rapid. This adverse event rate can be further reduced by focusing on the pharmacological action of Ephedra herb and Glycyrrhiza root. This study suggests that MKYK can be used more widely for painful afflictions.</p>
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Hyperthyroidism With Non-chylous Ascites: A Case Report
Shodai Takahashi, Kasumi Satoh, Manabu Okuyama, Nobuhisa Hirasawa, Hajime Nakae
Cureus ( Springer Science and Business Media LLC ) 2023年10月
研究論文（学術雑誌）
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Okura K.
Heart and Lung ( Heart and Lung ) 75 247 - 253 2026年01月
BACKGROUND: Optimizing ventilatory management for lung and diaphragm protection is crucial in mechanically ventilated patients. Although monitoring inspiratory effort is useful, some ventilators lack this capability. Conversely, diaphragm thickening fraction (DTF) may serve as a surrogate index of respiratory effort. However, its optimal cutoff value remains unclear. OBJECTIVES: This study aimed to investigate the relationship between DTF and P0.1, as a measure of respiratory effort, and to identify the optimal DTF threshold for excessive respiratory effort. METHODS: This single-center, prospective, cross-sectional study included critically ill adults receiving invasive mechanical ventilation between June 2023 and May 2024. DTF was measured using ultrasound, while P0.1 was assessed via an airway occlusion maneuver using a ventilator's built-in tool. Potentially injurious respiratory effort was defined as ΔP0.1 > 3.5 cmH2O. Daily data were collected from the onset of spontaneous breathing. The optimal DTF cutoff was determined using receiver operating characteristic (ROC) and precision-recall (PR) curves, with the Youden index and F1 score. The prediction accuracy of DTF was evaluated using the area under the curve (AUC). RESULTS: A total of 174 daily recordings from 70 patients were analyzed. Twenty-three (13 %) recordings indicated potentially injurious respiratory effort. The AUC of the ROC and PR curves were 0.938 (95 % confidence interval [CI]: 0.848 to 0.994) and 0.857 (95 % CI: 0.667 to 0.952), respectively. The optimal DTF cutoff was 35.7 %, yielding 96.0 % accuracy, 87.0 % sensitivity, and 97.4 % specificity. CONCLUSION: DTF correlates with P0.1 in mechanically ventilated patients. A 35.7 % DTF cutoff accurately identifies potentially injurious respiratory effort.
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何がトリアージと考えられてきたのか—わが国の学術研究におけるトリアージの用法についてのスコーピングレビュー—
島田 裕平, 三羽 恵梨子, 坂井 愛理, 石橋 真帆, 平澤 暢史, 南谷 健太, 冨尾 淳
日本災害医学会雑誌 ( 一般社団法人 日本災害医学会 ) 30 ( 2 ) 72 - 81 2025年05月
<p>【目的】国内学術研究におけるトリアージの用法を整理する。【方法】多領域の和文学術文献におけるトリアージの用法についてスコーピングレビューを実施した。対象文献の発行年は1990年から2023年とした。【結果】438件の文献がレビュー対象となった。トリアージの用法は「対象（者）の優先順位付け」という核を共有しつつも多義的であり、少なくとも7つの要素を含み得ることがわかった。医学系領域では、災害と救急の間では「死亡群」を含むか否かという大きな差異がみられたものの、分野ごとに具体的な局面を想定して議論する傾向があるために、トリアージの意味や文脈が安定していた。非医学系領域では、同じ分野でも文献ごとに異なるトリアージの局面が取り上げられており、各論者が各局面のトリアージを議論する結果、複数のトリアージ理解が併存する状況がみられた。【結語】用法の差異を踏まえたうえで、トリアージの学際的議論が交わされることが期待される。</p>
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臓器下臓器提供数0から拠点施設となった取り組み
平澤 暢史, 奥山 学, 中永 士師明
移植 ( 一般社団法人 日本移植学会 ) 60 ( Supplement ) s243_2 - s243_2 2025年
<p>【背景】秋田大学医学部附属病院は2016年の院内初の心停止下臓器提供を契機に、脳死下臓器提供のできる施設を目指してきた。2024年に当院初の脳死下臓器提供を行い、2025年に拠点施設となった、一連の取り組みを紹介する。</p><p>【活動内容】2016年にガイドラインに準拠した集中治療室の終末期認定制度を院内規約化した。年間約25例を終末期認定しており、うち6割程度に生命維持装置等の中止を行うなど、終末期ケアを実践してきた。2021年に高度救命救急センターに指定され、重症患者の受入が増加し、救急・集中治療を行う医師を増員した。これらの体制強化により、救命可能性が低い重症救急患者にもまずは集学治療を行い、救命不可能であると認定したら、生命維持装置の終了を含めた終末期ケアへ移行する、というやり方が標準化してきた。結果的に脳死とされうる状態の患者と、臓器提供を選択肢提示できる機会は増加した。また2018年より日本臓器移植ネットワークの院内体制整備支援事業を利用し、外部講師を招いて院内シミュレーションや講演会を開催してきた。2023年に臓器提供施設連携体制構築事業の連携施設となった。2024年に拠点施設の協力を得ながら初の脳死下臓器提供を行い、同年度中に小児を含めた３例を立て続けに経験した。</p><p>【結論】重症救急患者の初期治療から終末期ケアまで、一貫して充実した集学的医療の提供体制を整えたことで、脳死下臓器提供のできる施設へと成長した。</p>
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A case report of Kampo medicine use in severe mastitis
Saruta R.
Traditional and Kampo Medicine ( Traditional and Kampo Medicine ) 12 ( 1 ) 58 - 59 2025年
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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年11月
<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>