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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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Abe T., Saito K., Nagano T., Yamada Y., Ochiai H.
Thrombosis Research 247 109281 2025.3
Language：English Publishing type：Research paper (scientific journal) Publisher：Thrombosis Research
Background: Sepsis-induced disseminated intravascular coagulation (DIC) increases mortality in sepsis patients. Complement system activation is concomitant with sepsis-induced DIC; however, it is unclear how these two pathologies influence clinical parameters of sepsis individually and in combination, and which of the complement pathways activation is predominantly associated with mortality. Methods: In this ancillary analysis of a prospective observational study, 49 adult sepsis patients were assigned to four groups according to the absence/presence of DIC and complement activation. Effects of complement activation and DIC on clinical demographics including parameters of DIC, systemic severities, and 60-days all-cause mortality were assessed by comparing the groups. We analyzed each complement pathway by comparing Bb, C3a/C3 ratio, SC5b-9/C3 ratio, C4d, C4d/C4 ratio, C3a, C5a, and SC5b-9 between survivors/non-survivors both in all the patients and in the DIC+ subgroup. Results: Complement system activation induced thrombocytopenia and enhanced sepsis severity measured as APACHE2 and SOFA scores. 60-days all-cause mortality was different between groups, with 0 % in the complement activation alone group, 14 % in the DIC alone group and 66 % in the combined DIC and complement activation group. Bb and C3a/C3 and SC5b-9/C3 ratios were higher in non-survivors, with Bb and SC5b-9/C3 ratio still higher in DIC+ non-survivors. Conclusion: Complement activation worsen the severity of sepsis and cause thrombocytopenia. Co-occurrence of complement activation and DIC increased sepsis mortality. The alternative pathway of complement activation plays a major role in sepsis mortality.
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A simulation of ‘untreated deaths’ in the acute phase of The Nankai Trough Earthquake Reviewed
Fuse Akira, Onishi Mitsuo, Miyauchi Masato, Ochiai Hidenobu, Fuse Rimi, Oyama Hiroshi
Japanese Journal of Disaster Medicine 29 ( 3 ) 213 - 219 2024.10
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Association for Disaster Medicine
【Purpose】 Using simulation to determine measures for reducing the number of untreated deaths after The Nankai Trough Earthquake. 【Method】 An untreated death refers to a fatality occurring during the acute phase of a disaster due to insufficient medical care. Previously, employing a queuing model, we developed a discrete event simulation to model disaster medical response. Using this system, we calculated the count of severely injured individuals, the number of untreated deaths, and the untreated death rate (number of untreated deaths divided by number of seriously injured persons [%]) under current conditions and subsequent to the execution of disaster prevention and mitigation measures. 【Results/Discussion】 The simulated untreated death rates (%) for top eight prefectures with most injuries are as follows: Kochi prefecture (85.0%), Mie prefecture (81.5%), Wakayama prefecture (79.5%), Shizuoka prefecture (78.7%), Tokushima prefecture (75.4%), Ehime prefecture (66.7%), Aichi prefecture (64.1%), and Osaka prefecture (0.8%). The rate of reduction in untreated deaths is defined as the ratio of the number of untreated after disaster mitigation to the current number of untreated individuals. Following the implementation of disaster prevention and mitigation measures, untreated deaths in Aichi Prefecture decreased by 69.7%. Adopting similar measures, untreated deaths decreased by 80.7% in Shizuoka Prefecture, 70.9% in Mie Prefecture, and 85.7% in Osaka Prefecture. Additionally, Kochi Prefecture witnessed a 91.1% reduction in untreated deaths following the adoption of disaster prevention and mitigation measures. Implementing the same disaster prevention and mitigation measures as in Kochi Prefecture, led to a reduction of untreated deaths by 92.3% in Ehime Prefecture, 99.2% in Wakayama Prefecture, and 99.3% in Tokushima Prefecture. With the implementation of disaster prevention and mitigation measures, untreated deaths in many areas could be reduced to <30% compared to the current situation. In areas where the seriously injured bed occupancy rate (defined as number of seriously injured divided by number of beds) is <0.5, the untreated death rate is approximately 0.5. However, in areas where the seriously injured bed occupancy rate exceeds 0.5, the untreated death rate increases significantly. For instance, the untreated death rate reaches 70% in areas with a seriously injured bed occupancy rate of 1.0 and 80% in areas with a rate of 1.5. Thus, relying solely on DMAT medical resources is deemed unrealistic. 【Conclusion】 Using a disaster medical simulation system, we examined the untreated death rates in a simulated Nankai Trough Earthquake and drew the following conclusions. First, urgent improvements in earthquake resistance are needed in prefectures where the simulated untreated death rate exceeds 80%. Second, to maintain the untreated death rate below 5%, the bed occupancy rate for severely injured individuals should not exceed 0.5 in secondary medical care areas, i.e., medical districts that concentrate medical care for seriously injured people during a disaster. Third, implementing disaster prevention and mitigation measures akin to those in Aichi and Kochi prefectures could reduce the untreated death rate to below 30%. Finally, without significant improvements in disaster medicine to ensure all medical personnel are proficient in this area, it will remain challenging to secure sufficient medical resources to reduce the number of untreated deaths in The Nankai Trough Earthquake.
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Abe T., Kijima H., Ohuchida J., Hisashi Y., Tachioka S., Iwatani K., Sadohara K., Ameda T., Ochiai H.
JACC: Case Reports 29 ( 11 ) 102348 2024.6
Language：English Publishing type：Research paper (scientific journal) Publisher：JACC: Case Reports
Intrapericardial hernia is a diaphragmatic hernia that extremely rarely causes cardiac tamponade. We present a case of a cardiac tamponade caused by an intrapericardial hernia in a 78-year-old male patient with a history of coronary artery bypass grafting, mimicking ST-segment elevation myocardial infarction, which was successfully treated by emergent laparotomy.
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Changes in coagulation factor XIII activity during resuscitation for hemorrhagic shock
Yamada Yusuke, Abe Tomohiro, Tanohata Rina, Ochiai Hidenobu
Journal of Rural Medicine 19 ( 2 ) 76 - 82 2024.4
Language：English Publishing type：Research paper (scientific journal) Publisher：THE JAPANESE ASSOCIATION OF RURAL MEDICINE
DOI： 10.2185/jrm.2023-028
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Kubo Keisuke, Abe Tomohiro, Nagoshi Hideki, Ochiai Hidenobu
Journal of Rural Medicine 19 ( 2 ) 114 - 118 2024.4
Language：English Publishing type：Research paper (scientific journal) Publisher：THE JAPANESE ASSOCIATION OF RURAL MEDICINE
DOI： 10.2185/jrm.2023-009
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