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Faculty of Medicine College Hospital Anesthesiology |
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MARUTA Toyoaki
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Papers 【 display / non-display 】
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Maruta T., Hidaka K., Kouroki S., Koshida T., Kurogi M., Kage Y., Mizuno S., Shirasaka T., Yanagita T., Takahashi S., Takeya R., Tsuneyoshi I.
PLoS ONE 17 ( 10 October ) e0275751 2022.10
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：PLoS ONE
In small and large spinal dorsal root ganglion neurons, subtypes of voltage-gated sodium channels, such as NaV1.7, NaV1.8, and NaV1.9 are expressed with characteristically localized and may play different roles in pain transmission and intractable pain development. Selective stimulation of each specific subtype in vivo may elucidate its role of each subtype in pain. So far, this has been difficult with current technology. However, Optogenetics, a recently developed technique, has enabled selective activation or inhibition of specific neural circulation in vivo. Moreover, optogenetics had even been used to selectively excite NaV1.8-expressing dorsal root ganglion neurons to induce nocifensive behavior. In recent years, genetic modification technologies such as CRISPR/Cas9 have advanced, and various knock-in mice can be easily generated using such technology. We aimed to investigate the effects of selective optogenetic activation of NaV1.7-expressing afferents on mouse behavior. We used CRISPR/Cas9-mediated homologous recombination to generate bicistronic NaV1.7–iCre knock-in mice, which express iCre recombinase under the endogenous NaV1.7 gene promoter without disrupting NaV1.7. The Cre-driver mice were crossed with channelrhodopsin-2 (ChR2) Cre-reporter Ai32 mice to obtain NaV1.7iCre/+;Ai32/+, NaV1.7iCre/iCre;Ai32/+, NaV1.7iCre/+;Ai32/Ai32, and NaV1.7iCre/iCre;Ai32/Ai32 mice. Compared with wild–type mice behavior, no differences were observed in the behaviors associated with mechanical and thermal stimuli exhibited by mice of the aforementioned genotypes, indicating that the endogenous NaV1.7 gene was not affected by the targeted insertion of iCre. Blue light irradiation to the hind paw induced paw withdrawal by mice of all genotypes in a light power-dependent manner. The threshold and incidence of paw withdrawal and aversive behavior in a blue-lit room were dependent on ChR2 expression level; the strongest response was observed in NaV1.7iCre/iCre;Ai32/Ai32 mice. Thus, we developed a non-invasive pain model in which peripheral nociceptors were optically activated in free-moving transgenic NaV1.7–ChR2 mice.
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Hidaka K., Maruta T., Koshida T., Kurogi M., Kage Y., Kouroki S., Shirasaka T., Takeya R., Tsuneyoshi I.
Molecular Pain 18 17448069221089784 - 12 2022.3
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Molecular Pain
Pulsed radiofrequency (PRF) therapy is one of the most common treatment options for neuropathic pain, albeit the underlying mechanism has not been hitherto elucidated. In this study, we investigated the efficacy and mechanism of PRF therapy on resiniferatoxin (RTX)-induced mechanical allodynia, which has been used as a model of postherpetic neuralgia (PHN). Adult male rats were intraperitoneally injected with a vehicle or RTX. Furthermore, PRF current was applied on a unilateral sciatic nerve in all RTX-treated rats. On both ipsilateral and contralateral sides, the paw mechanical withdrawal thresholds were examined and L4-6 dorsal root ganglia (DRG) were harvested. In the DRG of rats with RTX-induced mechanical allodynia, NaV1.7, a voltage-gated Na+ channel, was upregulated following the enhancement of extracellular signal-regulated kinase phosphorylation. Early PRF therapy, which was applied 1 week after RTX exposure, suppressed this NaV1.7 upregulation and showed an anti-allodynic effect; however, late PRF therapy, which was applied after 5 weeks of RTX exposure, failed to inhibit allodynia. Interestingly, late PRF therapy became effective after daily tramadol administration for 7 days, starting from 2 weeks after RTX exposure. Both early PRF therapy and late PRF therapy combined with early tramadol treatment suppressed NaV1.7 upregulation in the DRG of rats with RTX-induced mechanical allodynia. Therefore, NaV1.7 upregulation in DRG is related to the development of RTX-induced neuropathic pain; moreover, PRF therapy may be effective in the clinical management of patients with PHN via NaV1.7 upregulation inhibition.
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Epidural Anesthesia and Continuous Epidural Analgesia in a Pediatric Patient With Pelizaeus-Merzbacher Disease: A Case Report. Reviewed
Maruta T, Watanabe Y, Nagata Y, Kashino R, Tsuneyoshi I
Cureus 14 ( 10 ) e29983 2022.10
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal)
DOI： 10.7759/cureus.29983
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Kouroki S., Maruta T., Tsuneyoshi I.
JA Clinical Reports 8 ( 1 ) 27 2022.4
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：JA Clinical Reports
Background: Cryoprecipitate, which contains fibrinogen and factor VIII in large quantities, is concentrated from fresh frozen plasma, and it has hemostatic effects in severe bleeding. We retrospectively examined the effects of cryoprecipitate on the increase in fibrinogen levels in patients with excessive intraoperative blood loss. Methods: Ninety-seven patients who were administered cryoprecipitate during surgery between June 2014 and May 2019 were enrolled in our study and categorized according to the volume of intraoperative blood loss as follows: group A, 2000–5000 mL; group B, 5000–10,000 mL; group C, > 10,000 mL. Data were extracted from electronic medical records and electronic anesthesia records. The primary endpoint was an increase in the fibrinogen level after the administration of cryoprecipitate. Results: Nine patients with no fibrinogen data and four patients with a bleeding volume of less than 2000 mL were excluded; thus, 84 patients (A: n = 36, B: n = 37, C: n = 11) were evaluated. The mean intraoperative blood loss (mL) in groups A, B, and C were 3348 ± 791, 6688 ± 1225, and 14,281 ± 5142, respectively. The fibrinogen levels (mg/dL) before cryoprecipitate administration in groups A, B, and C were 189 ± 94, 113 ± 42, and 83 ± 29, respectively (p < 0.05 among the groups). The increase in fibrinogen level (mg/dL) after cryoprecipitate administration in group C was significantly greater than that in group A (84 ± 34 versus 50 ± 36, p < 0.01). Conclusions: The results of this study indicate that the effect of cryoprecipitate on the increase in fibrinogen level was most apparent in patients with excessive intraoperative blood loss ≥ 10,000 mL. In addition, most patients with intraoperative blood loss ≥ 5000 mL had fibrinogen levels < 150 mg/dL which improved to ≥ 150 mg/dL after cryoprecipitate administration in approximately 70% of patients. Therefore, cryoprecipitate administration should be considered for patients with hypofibrinogenemia (≤ 150 mg/dL) experiencing severe bleeding (e.g., ≥ 5000 mL) and rapid administration of cryoprecipitate is necessary to maximize the hemostatic effect, especially when the bleeding volume exceeds 10,000 ml.
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術中出血に対するクリオプレシピテートの使用効果の検討 後ろ向き研究 Reviewed
興梠聡志，丸田豊明，恒吉勇男
麻酔 70 ( 8 ) 823 - 828 2021.8
Language：Japanese Publishing type：Research paper (scientific journal)
Books 【 display / non-display 】
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麻酔偶発症AtoZ
丸田 豊明
文光堂 2017.6
Total pages：670 Language：Japanese
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麻酔偶発症A to Z
丸田豊明，恒吉勇男（ Role： Contributor , 静脈炎．）
文光堂 2017.6
Responsible for pages：548 Language：Japanese Book type：Scholarly book
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麻酔偶発症A to Z
丸田豊明，恒吉勇男（ Role： Contributor , 抹消静脈カテーテルによる血腫，血栓，塞栓．）
文光堂 2017.6
Responsible for pages：546-547 Language：Japanese Book type：Scholarly book
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麻酔偶発症A to Z
丸田豊明，恒吉勇男（ Role： Contributor , 抹消静脈カテーテルの断裂・遺残．）
文光堂 2017.6
Responsible for pages：545 Language：Japanese Book type：Scholarly book
MISC 【 display / non-display 】
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気管挿管における気管チューブの理想的なカフ圧‐時間曲線の検討
河野太郎, 指宿昌一郎, 丸田豊明, 矢野武志, 児玉芳史, 石山健次郎, 新福玄二, 森信一郎, 恒吉勇男, 恒吉勇男
日本集中治療医学会学術集会(Web) 45th ( Suppl. ) ROMBUNNO.P1‐1 (WEB ONLY) - 1] 2018.2
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution) Publisher：(一社)日本集中治療医学会
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先天性QT延長症候群でフェニレフリンが多源性心室頻拍とS‐ICDの誘発試験に関与した1症例
河野太郎, 丸田豊明, 児玉芳史, 長嶺佳弘, 内村修二, 溜渕昌美, 金丸容子, 恒吉勇男
Cardiovascular Anesthesia 21 ( Suppl ) 369 - 369 2017.9
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution) Publisher：(一社)日本心臓血管麻酔学会
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丸田豊明, 興梠聡志, 黒木俊介, 長嶺佳弘, 児玉芳史, 門田瑶子, 恒吉勇男
日本小児麻酔学会誌 23 ( 1 ) 169‐173 - 173 2017.8
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution) Publisher：日本小児麻酔学会
小児では母斑や血管腫に対する皮膚レーザー照射術が全身麻酔下に行われることが多く,術後鎮痛のために術中にさまざまな鎮痛薬が用いられる.当施設でのアセトアミノフェン静注薬導入以前における術中鎮痛薬使用の有無と使用した鎮痛薬の種類や術後の鎮痛薬使用の有無などを後ろ向きに調査した.2013年1月から2014年6月迄に入院治療として全身麻酔下にレーザー照射術を施行された1〜19歳の小児.未成年の患者77症例が対象となった.年齢層は2〜3歳が最も多く,5歳迄が全体の約80%を占めた.術中鎮痛薬はペンタゾシン単独・併用が45%で最も多く,次いでアセトアミノフェン座薬,フルルビプロフェンの単独・併用がそれぞれ33%,31%と多かった.鎮痛薬未使用は12%であった.術後に鎮痛薬を使用したのは,5症例と少なかった.術中鎮痛薬はペンタゾシンが好まれる傾向があったが,ほとんどの症例がセボフルラン麻酔であり,覚醒時興奮を予防・治療するために使用されたと考えられた.(著者抄録)
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児玉芳史, 君安貴寛, 丸田豊明, 太田尾剛, 白阪哲朗, 恒吉勇男
日本循環制御医学会総会(Web) 38th ROMBUNNO.O‐11 (WEB ONLY) - 70 2017.6
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution) Publisher：日本循環制御医学会
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当施設における末梢挿入型中心静脈カテーテル留置症例の安全性の検討‐がん患者と非がん患者の後ろ向き比較‐
丸田望, 丸田豊明, 高橋稔之, 和田徹也
Palliative Care Research (Web) 12 ( 1 ) 169‐174(J‐STAGE) - 174 2017.1
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution) Publisher：(NPO)日本緩和医療学会
【目的】末梢挿入型中心静脈カテーテル(peripherally inserted central venous catheter:PICC)留置症例をがん患者と非がん患者で比較し,安全性の検討を行った.【方法】PICCを留置した患者で留置目的・留置期間・合併症の有無などを後ろ向きに比較した.【結果】がん患者は88例,非がん患者は69例であった(以下,がん患者vs.非がん患者).留置目的は高カロリー輸液投与が45 vs. 51例,末梢静脈路確保困難が40 vs. 12例であった(p=0.0022).留置期間は15(6-39) vs. 21(12-40)日であった(p<0.0001).PICC留置に伴う合併症を認めたのは8 vs. 9例で有意差はなかったが,カテーテル関連血流感染は非がん患者で多かった(0.9 vs. 2.0件/1000カテーテル日,p=0.041).【考察】PICCによる合併症発生率はどちらも低く,PICCの安全性が示された.(著者抄録)
DOI： 10.2512/jspm.12.169
Presentations 【 display / non-display 】
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帯状疱疹後神経痛モデルラットにおける高周波パルス療法の作用機序の検討．
日髙康太郎，丸田豊明，越田智広，興梠聡志，白阪哲朗，恒吉勇男
第43回日本疼痛学会
Event date： 2021.12.10 - 2021.12.11
Language：Japanese Presentation type：Oral presentation (general)
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レシニフェラトキシン誘発性疼痛ラットでのトラマドール治療後の高周波パルス療法の有効性と作用機序の検討（優秀演題）．
日髙康太郎，丸田豊明，門田瑶子，興梠聡志，越田智広，渡部由美，山賀昌治，恒吉勇男
日本ペインクリニック学会第55回大会
Event date： 2021.7.22 - 2021.7.24
Language：Japanese Presentation type：Oral presentation (general)
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オプトジェネティクスを用いた末梢神経疼痛モデル動物の開発（優秀演題（基礎編））
丸田豊明，越田智広，日髙康太郎，黒木未央，白阪哲朗，恒吉勇男
第42回日本疼痛学会 2020.12.4
Event date： 2020.12.4 - 2020.12.5
Language：Japanese Presentation type：Oral presentation (general)
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ロボット支援腹腔鏡下前立腺摘出術で生じた全身性皮下気腫の一例．
永田悠紀子，川﨑祐子，押川 隆，加藤彩鳥，丸田豊明，恒吉勇男
日本臨床麻酔学会第40回大会 2020.11
Event date： 2020.11.6 - 2020.12.14
Language：Japanese
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キサリプラチン誘発神経障害性疼痛に関連する細胞内シグナル分子の解析．
根本隆行，丸田豊明，武谷 立，恒吉勇男，岩本隆宏
第49回日本心脈管作動物質学会 2020.2.7
Event date： 2020.2.7 - 2020.2.8
Language：Japanese Presentation type：Poster presentation
Grant-in-Aid for Scientific Research 【 display / non-display 】
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移植患者の免疫抑制薬による疼痛の発症メカニズムを明らかにしその治療法を確立する
Grant number：22K0903701 2022.04 - 2025.03
独立行政法人日本学術振興会 科学研究費補助金 基盤研究(C)
Authorship：Coinvestigator(s)
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オプトジェネティクスを用いた神経障害性疼痛モデルマウスの作製と疼痛機序の解明
Grant number：21K08925 2021.04 - 2024.03
独立行政法人日本学術振興会 科学研究費補助金 基盤研究(C)
Authorship：Principal investigator
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オプトジェネティクスを用いた光による痛み制御 ~実験動物の開発と疼痛機序の解明~
2018 - 2021.03
科学研究費補助金 基盤研究(C)
Other research activities 【 display / non-display 】
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BAOJ Medical and Nursing
2017.03
査読
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SDRP Journal Of Anesthesia & Surgery
2016.12
査読