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Faculty of Medicine School of Medicine Department of Medicine of Pathophysiological Diagnosis and Therapy, Emergency, Critical Care, and Disaster Medicine |
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OCHIAI Hidenobu
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Degree 【 display / non-display 】
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Ph.D (Medicine) ( 2005.3 University of Miyazaki )
Papers 【 display / non-display 】
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Matsuoka H, Abe T, Yonaha T, Yano T, Taniguchi M, Nagano T, Tsuneyoshi I, Ochiai H
Cureus 18 ( 2 ) e102924 2026.2
Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC
Acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI) represent critical complications that significantly burden the management of pediatric patients with extensive burns. We present a case of a four-year-old boy who sustained severe burns covering 56% of his total body (Burn Index 29). The patient developed ARDS on Day 3, which led to the initiation of venovenous extracorporeal membrane oxygenation (ECMO) on Day 5. Following the subsequent development of AKI and fluid overload, continuous renal replacement therapy (CRRT) was introduced on Day 6. To overcome the limitations of vascular access common in pediatric patients, a novel integrated approach was employed by connecting the CRRT circuit to a unique bypass between the ECMO limbs. This integrated system allowed for seamless treatment and effective fluid management, resulting in the resolution of pulmonary edema and a significant improvement in respiratory function. The patient was successfully weaned from ECMO on Day 10 and CRRT on Day 13, eventually being discharged on Day 90 following multiple skin grafting procedures. This case highlights that the integration of CRRT into an ECMO bypass line is a simple, safe, and effective modality for the life-saving treatment of pediatric severe burns complicated by multi-organ failure.
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Koreeda H., Yoshikawa N., Sasaki A., Tasaki K., Itoh H., Ochiai H., Ikeda R.
European Journal of Hospital Pharmacy 2026
Language：English Publishing type：Research paper (scientific journal) Publisher：European Journal of Hospital Pharmacy
A 68-year-old male with severe burns was admitted for treatment. During the prolonged hospitalisation, discrepancies were observed between estimated glomerular filtration rate (eGFR) based on serum creatinine (eGFRcre) and actual renal function, as indicated by vancomycin therapeutic drug monitoring. Serum cystatin C measurement revealed a difference between eGFR based on serum cystatin C (eGFRcys) and eGFRcre. The patient experienced drug-induced liver injury, likely due to an inaccurate renal function assessment using serum creatinine. Adjusting drug doses based on eGFRcys improved clinical outcomes. Therefore, eGFRcre may overestimate renal function in patients with decreased muscle mass from prolonged hospitalisation and reduced physical activity. In emergency medicine, especially for patients with conditions affecting muscle mass, eGFRcys may be a more reliable marker for renal function evaluation than eGFRcre. Hence, alternative methods should be considered for assessing renal function in special populations to ensure appropriate drug dosing and prevent adverse effects.
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Sasaki A., Nakajima M., Shinozaki T., Sasabuchi Y., Ohbe H., Kaszynski R.H., Kimura Y., Morita K., Goto T., Aiyama Y., Nakayama I., Matsui H., Fushimi K., Ochiai H., Yasunaga H.
Journal of Intensive Care 13 ( 1 ) 57 2025.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Intensive Care
Background: In patients with pneumonia requiring mechanical ventilation, increased airway secretions are associated with prolonged mechanical ventilation, but the effect of mucoactive agents remains unclear. The present study aimed to investigate the association between early administration of mucoactive agents and in-hospital mortality in patients with pneumonia requiring mechanical ventilation. Methods: We conducted a retrospective cohort study using the Japanese Diagnosis Procedure Combination database, a nationwide inpatient database. Adult patients were eligible if they had a primary diagnosis of pneumonia and required invasive mechanical ventilation within 2 days of admission, with ventilation continued for ≥ 2 days between April 2012 and March 2023. Patients were divided into those who received at least one mucoactive agent within 2 days after the initiation of mechanical ventilation (mucoactive agent group) and those who did not (control group). Mucoactive agents included ambroxol (oral), bromhexine (oral, intravenous and nebulized), fudosteine (oral), carbocisteine (oral) and N-acetylcysteine (nebulized). We performed a propensity score overlap weighting analysis to compare in-hospital mortality. The number of ventilator-free days at 28 days was assessed as a secondary outcome. We also performed sensitivity analyses using inverse probability of treatment weighting, generalized estimating equations, and doubly robust methods. Results: Eligible patients (n = 10,942) were categorized into the mucoactive agent group (n = 2246) or control group (n = 8696). The most commonly prescribed mucoactive agent was carbocisteine (oral). After overlap weighting, in-hospital mortality was significantly lower in the mucoactive agent group than in the control group (25.2% vs. 27.5%; risk difference, − 2.3%; 95% confidence interval, − 4.4% to − 0.3%; p = 0.028). Ventilator-free days at 28 days did not significantly differ between the mucoactive agent group and the control group. Sensitivity analyses yielded similar results. Conclusions: In patients with ventilated pneumonia, early administration of mucoactive agents was associated with lower in-hospital mortality.
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北條 健人, 田中 早紀, 安部 智大, 落合 秀信
Acute medicine & surgery 12 ( 1 ) e70079 2025.8
Language：English Publishing type：Research paper (scientific journal) Publisher：John Wiley & Sons
Background
The ingestion of glyphosate herbicides can cause severe acute kidney injury. We present a case of glyphosate poisoning in which creatinine levels were falsely elevated when measured using a dry chemistry analyzer.
Case Presentation
An 83-year-old man ingested glyphosate herbicide during a suicide attempt and presented with gastrointestinal symptoms. A dry chemistry analyzer showed high creatinine levels (10.62 mg/dL); thus, the patient was transported to our hospital for renal replacement therapy. However, enzymatic testing showed a lower creatinine level (1.36 mg/dL). Further investigation comparing creatinine measurements revealed a high creatinine level only through the dry chemistry method, despite the relatively low glyphosate concentration (55 mg/L).
Conclusion
The dry chemistry method falsely shows an elevated creatinine value, which may affect clinical decisions regarding the management of patients with glyphosate poisoning. Careful interpretation of creatinine measurements using the dry chemistry method is important in glyphosate poisoning cases. -
投稿 症例 細菌性髄膜炎の経過中に低カリウム血症を契機にBrugada症候群様の心電図異常を呈し,心室細動をきたした1例 Reviewed
法化図 陽一, 中平 孝明, 日髙 颯之介, 北條 健人, 落合 秀信
内科 135 ( 6 ) 1397 - 1400 2025.6
Publishing type：Research paper (scientific journal) Publisher：南江堂
Books 【 display / non-display 】
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今日の治療指針2023年版 私はこう治療している
落合 秀信（ Role： Contributor , 【中毒性疾患】塩素ガス中毒）
医学書院 2023.1
Responsible for pages：143-143 Book type：Scholarly book
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今日の治療指針2022年版 私はこう治療している
落合 秀信（ Role： Contributor , 【中毒性疾患】シアン中毒）
医学書院 2022.1
Responsible for pages：143-143 Book type：Scholarly book
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今日の治療指針2021年版 私はこう治療している
落合 秀信（ Role： Contributor , 【中毒性疾患】酸・アルカリ化学損傷）
医学書院 2021.1
Responsible for pages：146-147 Book type：Scholarly book
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今日の治療指針2020年版 私はこう治療している
落合 秀信（ Role： Contributor , 【中毒性疾患】グリホサート・グルホシネート中毒）
医学書院 2020.1
Responsible for pages：134-135 Language：Japanese Book type：Scholarly book
MISC 【 display / non-display 】
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Azuma M., Nakada H., Takei M., Nakamura K., Katsuragawa S., Shinkawa N., Terada T., Masuda R., Hattori Y., Ide T., Kimura A., Shimomura M., Kawano M., Matsumura K., Meiri T., Ochiai H., Hirai T.
Emergency Radiology 29 ( 2 ) 425 2022.4
Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：Emergency Radiology
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Complement-mediated thrombotic microangiopathy secondary to sepsis-induced disseminated intravascular coagulation successfully treated with eculizumab: A case report.
Abe T, Sasaki A, Ueda T, Miyakawa Y, Ochiai H.
Wolters Kluwer Health 96 ( 6 ) e6056 2017.2
Language：English Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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ノロウイルス性胃腸炎に合併した劇症型Clostridium perfringens感染症の1例 Reviewed
長野健彦, 安部智大, 長嶺育弘, 今井光一, 松岡博史, 金丸勝弘, 落合秀信, 牧原真治, 廣兼民徳
宮崎県医師会医学会誌 40 ( 1 ) 60 - 64 2016.3
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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【E Word 私が大切にしている言葉】及ばざるは過ぎたるよりまされり 平常心
落合秀信
Emergency Care 26 ( 8 ) 1 - 1 2013.7
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：メディカ出版
Presentations 【 display / non-display 】
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地域医療機関と宮崎大学救命救急センターとの連携の過去・現在・未来について
落合秀信
第23回宮崎生協病院地域連携懇談会 (宮崎)
Event date： 2023.3.24
Presentation type：Oral presentation (invited, special)
Venue：宮崎
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宮崎大学における重度四肢外傷治療の実情と今後の課題
日吉優，帖佐悦男，中村嘉宏，今里浩之，平川雄介，山口洋一朗，森田雄大，落合秀信
第57回宮崎救急医学会 (宮崎)
Event date： 2023.3.18
Presentation type：Oral presentation (general)
Venue：宮崎
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宮崎県北部地域精神科救急疾患対応の現状と課題について
長嶺育弘，森久保裕，島津志帆子，岩本和樹，佐藤由佳子，出口ゆかり，木佐貫ゆかり，金丸勝弘，落合秀信
第57回宮崎救急医学会 (宮崎)
Event date： 2023.3.18
Presentation type：Oral presentation (general)
Venue：宮崎
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宮崎県北部地域救急医療体制の変化及び今後の課題について
長嶺育弘，森久保裕，島津志帆子，岩本和樹，木佐貫ゆかり，金丸勝弘，落合秀信
第57回宮崎救急医学会 (宮崎)
Event date： 2023.3.18
Presentation type：Oral presentation (general)
Venue：宮崎
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胃石形成により循環不全が遷延したアムロジピン中毒に対して上部消化管内視鏡を用いて洗浄・胃石除去を施行した1例
畠中健吾, 工藤陽平, 落合秀信
第6回日本臨床・分析中毒学会総会・学術集会 (川崎)
Event date： 2023.3.11
Presentation type：Oral presentation (general)
Venue：川崎