Eizo Watanabe

Mesenteric Diatrizoate Pooling Mimicking an Anastomotic Leak in Multi‐Organ Dysfunction

Ryusuke Katsuki, Masanobu Tsuda, Takayuki Irahara, Takayuki Kai et autres

In patients with multi-organ dysfunction following severe physiological insult, such as prolonged cardiac arrest, enteral diatrizoate can be transmurally absorbed and sequestered within a contused mesentery. This retention mimics an active anastomotic leak on CT; clinical stability and the absence of fluid …

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Diagnostic performance of package insert-based screening for potential drug–drug interactions in ICU patients receiving injectable medications: a retrospective diagnostic accuracy study using Lexi-Interact as the comparator in Japan

Takahiro Kato, Noriko Yasukawa, Eriko Uno, Kenta Kanamori et autres

BACKGROUND: No established gold standard exists for identifying potential drug-drug interactions (pDDIs). In Japan, package inserts are commonly used for pDDI screening in clinical practice, whereas internationally curated databases such as Lexi-Interact serve widely as clinical decision support tools. However, the performance …

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Re: When Day-1 IL-6 Predicts Septic DIC—Capturing Imminent Immunothrombosis Rather Than General Risk

Masayuki Ozaki, Kosuke Kato, Eizo Watanabe

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Low FXIII activity levels in patients with vascular anomalies, not in patients with trauma-induced coagulopathy

Hiroaki Otsubo, Tsuguaki Terashima, Mai Terashima, Siqiang Gao et autres

Patients with localized intravascular coagulopathy (LIC) related to vascular anomalies occasionally suffer from hemorrhage and delayed wound healing, presumably due to consumptive reduction of fibrinogen and platelets. However, LIC patients with normal levels of platelets and fibrinogen can be hemorrhagic for unknown …

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Experimental evaluation of infusion methods and administration speeds in confined spaces during urban search and rescue operations

Takayuki Irahara, Taigo Sakamoto, Teppei Minamida, Masamitsu Shirokawa et autres

Introduction Confined space (CS) medicine is required for urban search and rescue operations, particularly for victims with crush syndrome. Adaptable infusion techniques are sometimes required for each rescue setting. However, the knowledge of infusion methods and speeds in CS is limited. Aim …

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Epigallocatechin gallate increases fatty acid oxidation but not 24-hour survival in lipopolysaccharide-induced endotoxic shock in mice

Takayuki Irahara, Ryusuke Katsuki, Dai Oishi, Tsuguaki Terashima et autres

Purpose: This study aimed to explore the effects of epigallocatechin gallate (EGCG) in critically ill patients using a mouse model.Methods: C57BL/6 mice were divided into control and EGCG groups (n=8 per group). The EGCG group received a 0.1% EGCG solution for 2 …

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P0815 Oral alpha 4 beta 7 (α4β7) integrin antagonist EA1080 (NSHO-101) demonstrates target engagement and α4β7 integrin receptor occupancy following once-daily administration in healthy volunteers

B G Feagan, Yoshimitsu Yazawa, Tatsunori Seki, Eizo Watanabe et autres

Abstract Background EA1080 (NSHO-101) is a selective, oral small molecule α4β7 integrin antagonist being advanced for the treatment of inflammatory bowel disease (IBD). EA1080 (NSHO-101) was safe and well tolerated and resulted in near complete inhibition of MAdCAM-1 binding to α4β7 integrin …

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A Case of Necrotizing Fasciitis in Which Interleukin‐6 Measurement Helped in the Decision for Large‐Scale Amputation of the Left Shoulder and Arm

Zuzanna Granek, Seina Osakabe, Yuka Kajita, Takayuki Irahara et autres

Background: Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with rapid progression of necrosis. Early debridement and further surgical procedures are essential, but decision-making is often difficult. Serum interleukin-6 (IL-6) may serve as a valuable diagnostic parameter for monitoring the patient's …

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Immunoadjuvant therapy in the regulation of cell death in sepsis: recent advances and future directions

Md. Monirul Islam, Eizo Watanabe, Umme Salma, Masayuki Ozaki et autres

Sepsis is characterized by a concomitant early pro-inflammatory response by immune cells to an infection, and an opposing anti-inflammatory response that results in protracted immunosuppression. The primary pathological event in sepsis is widespread programmed cell death, or cellular self-sacrifice, of innate and …

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Detection of Legionella species other than Legionella pneumophila in formalin‐fixed paraffin‐embedded tissue: An autopsy case study

Miho Riku, Ritsuko Nakamura, Tsuguaki Terashima, Daisuke Sakanashi et autres

Diagnosing the cause of death can be challenging, particularly for patients with no prior history of visits to the treating hospital. We encountered a case involving a 76-year-old male who was discovered in a state of cardiopulmonary arrest at his home and …

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The pathophysiology of sepsis and autophagy

Eizo Watanabe, Goichi Honda

敗血症は，「感染に対する制御不十分な生体反応に起因する，生命に危機を及ぼす臓器障害」であり，その生体反応に介入し制御を取り戻すことが敗血症治療の根幹である．敗血症病態の進展において，様々な細胞死が関わっているため，制御すべき生体反応として，重要臓器細胞や免疫担当細胞の細胞死をターゲットとして研究がなされてきている．オートファジーはII型プログラム細胞死と言われてはいたものの，その定義としては「細胞の自己成分を細胞内消化器官であるリソソームに運び込み分解する機構」であり，細胞死に関連はするが，オートファジー自体が細胞死を意味するものではない．過剰なオートファジーは細胞死を惹起し得るが，オートファジーは生命維持に必須の生体保護システムであり，敗血症のような大きな侵襲が加わっている環境では，多くの臓器でオートファジーは抑制される傾向となる．したがって，敗血症治療戦略としてオートファジーの停滞を防止することが重要である．

Characteristics of inflammation and nutritional metabolism in patients with COVID‐19 pneumonia

Takayuki Irahara, Subaru Tanabe, Salma Umme, Masayuki Ozaki et autres

【目的】COVID‐19肺炎の炎症と栄養代謝動態の特徴を明らかにし, 治療的介入の可能性につき考察する. 【対象と方法】当院救急ICUにCOVID‐19肺炎の診断で入室した患者28名につき, 炎症や栄養代謝に関する血液検査や間接熱量測定にて得られたデータを分析した. 【結果】COVID‐19重症度の内訳は中等症18例, 重症10例であった. 重症は全例に挿管管理を要し4例にvv‐ECMO管理を要した. 炎症データは重症で有意に高くリンパ球数が重症で有意に低下していた（p=0.005）. 栄養代謝ではCONUT値およびPGC‐1α濃度が重症で有意に高値であった（p=0.03, 0.003）. 間接熱量測定を行い得た5例では通常肺炎と比して脂質酸化量が低く呼吸商は高い傾向があった.【結語】COVID‐19肺炎では重症度に応じて高度炎症および免疫麻痺状態に陥っており, 栄養学的リスクも高いことが示唆された. また特有の栄養代謝動態の変化があり栄養療法において考慮すべきと思われた.

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