Osamu Tasaki

Osaka University | Handai · School of Medicine

Zinc plays a role in immune function. This study aimed to investigate the clinical significance of zinc levels in patients with severe trauma by examining the association between serum zinc levels and infectious complications. Inclusion criteria were hospitalization of 2 weeks or more; Abbreviated Injury Scale score of 3 or more; zinc levels measur...

Background: Early intervention in prehospital settings is important for treating patients with acute coronary syndrome (ACS). Emergency medical technicians (EMTs) are the essential first responders who treat these patients, and their current attitudes towards electrocardiograms (ECGs) have not been identified. This study investigated the awareness...

A limited number of studies have investigated the clinical characteristics of snakebite envenomation by exotic (non-native) snakes in Japan. This study reviewed the literature to determine the status and risk of bites by exotic pet snakes in Japan. We reviewed reports of snakebite due to exotic snakes in Japan published between 2000 and 2022, exclu...

It is well known that oxidative stress causes certain diseases and organ damage. However, roles of oxidative stress in the acute phase of critical patients remain to be elucidated. This study aimed to investigate the balance of oxidative and antioxidative system and to clarify the association between oxidative stress and mortality in critically ill...

When responding to disasters, emergency preparedness is essential to ensure that disaster activities are performed smoothly, safely and efficiently. Investigations on the Fukushima accident revealed that lack of preparedness, poor communication and unsuitable emergency measures contributed to an inadequate emergency response to the nuclear disaster...

To ensure human resource availability for a smooth response during various types of disasters, there is a need to improve the intent of those involved in responding to each hazard type. However, Disaster Medical Assistance Team personnel’s intent to engage with specific hazards has yet to be clarified. This study therefore aimed to clarify the fact...

Introduction Different disaster activities should be performed smoothly. In relation to this, human resources for disaster activities must be secured. To achieve a stable supply of human resources, it is essential to improve the intentions of individuals responding to each type of disaster. However, the current intention of Disaster Medical Assista...

Background Starting infusion at a rate based on the Baxter formula is the global standard. However, with this infusion formula, an excessive amount of fluid may be stored inside the body (fluid creep), which may lead to severe respiratory disorders or abdominal compartment syndrome. The present study explored whether the Baxter formula or the Modif...

Background: Neutrophil extracellular traps (NETs) are fibrous structures released from activated neutrophils. NET formation has been reported to be associated with acute respiratory distress syndrome (ARDS). However, there are no reports dealing with serial changes of NET formation in tracheal aspirate of ARDS patients. Case presentation: We rep...

Introduction: Repulsive guidance molecule a (RGMa) is a key protein that negatively regulates neuronal regeneration as its inhibition enhances axonal growth and promotes functional recovery in animal models of spinal cord injury. However, the role of RGMa in traumatic brain injury (TBI) remains elusive. This study aimed to clarify TBI-responsive R...

Venous thromboembolism (VTE) is a life-threatening complication after trauma. Several studies have reported VTE prophylaxis using low-molecular-weight heparin; however, there is no consensus for prophylaxis after trauma. This study aimed to assess the efficacy and safety of our new anticoagulation therapy protocol using unfractionated heparin (UFH)...

Aim This study aimed to evaluate the relationship between fecal organic acids and mortality in critically ill patients. Methods This retrospective study included 128 patients who fulfilled the criteria of systemic inflammatory response syndrome and had a serum C‐reactive protein level of greater than 10 mg/dL. Patients were treated in the intensiv...

Background Although the effects of the trauma center(TC) were researched in several studies, there have been few studies on changes in the regional mortality due to the implementation of a TC. An emergency medical center (EMC) and TC were implemented at Nagasaki University Hospital (NUH) for the first time in the Nagasaki medical region of Japan in...

Background: Disseminated intravascular coagulation (DIC) associated with multiple organ dysfunction syndrome (MODS) plays pivotal roles in severe sepsis. Objectives: We performed a multicenter, prospective data collection study and retrospectively analyzed the data to confirm the role of DIC in severe sepsis. Methods: Eligible patients were IC...

Aim Because severe trauma patients frequently manifest coagulopathy, it is extremely important to detect venous thromboembolism (VTE) in the acute phase. However, no reference value for D‐dimer in post‐traumatic VTE has been reported given the substantial increase in its levels after injury. Therefore, this study evaluates the ability of our screen...

Introduction: The preventive association of synbiotics therapy has not been thoroughly clarified in mechanically ventilated patients. The purpose of this study was to evaluate whether synbiotics therapy has preventive association against septic complications in ventilated critically ill patients. Methods: Critically ill patients who were mechani...

Fig. S1. (A–C) FAX‐OCR form developed for the Japanese Association for Acute Medicine's out‐of‐hospital cardiac arrest Registry.

Background: Infection in patients with systemic inflammation is difficult to diagnose with a single biomarker. We aimed to clarify the time course of change in the gene expression profile of innate immune receptors in infectious or sterile inflammation and to establish an early diagnostic method using canonical discriminant analysis (CDA) of the g...

Study/Objective To assess the role of prefectural Disaster Medical Assistance Team (DMAT) headquarters, on the safety management of dispatching DMAT to earthquake-hit areas, and the preparation of the advance agreement between the prefecture and relevant organizations. Background Nagasaki prefecture is located next to Kumamoto prefecture. Immediat...

A 66-year-old woman was admitted to our hospital with right chest pain without any memory of trauma. Vital signs were tachypneic, tachycardic (112/min), normotensive (119/84mmHg) and normothermic (36.1 degrees centigrade). Chest contrast-enhanced CT demonstrated a large hemothorax with fractures of ribs 11 and 12. Active bleeding from the right inf...

Aims: The purpose of this study was to predict the clinical course by intracranial pressure (ICP) or cerebral perfusion pressure (CPP) in the acute phase and prognosis in patients with severe head trauma who underwent therapeutic mild hypothermia (HT). Methods: A consecutive 143 patients treated with HT for intracranial hypertension (ICH) in two tr...

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Case A 61‐year‐old man who was hospitalized with schizophrenia in a psychiatric hospital drank hot water estimated to be 90°C. Eight hours after injury, laryngopharynx edema gradually progressed, and his breathing deteriorated. Upon arrival at our emergency room, we secured his respiratory tract by nasal intubation under a bronchoscope. Outcome Th...

Cases Traumatic intracranial aneurysm following blunt head injury is uncommon but can be induced by extension of skull base fracture and causes unexpected hemorrhagic complications. We present two cases of traumatic intracranial aneurysm in the paraclinoid area that was revealed by delayed massive epistaxis. Lack of initial neurological deficits om...

Objective: We aimed to clarify the change in rSO2, blood pressure (BP) and arterial oxygen saturation (SpO2) in CPA patients who got return of spontaneous circulation (ROSC). Method: We measured rSO2 in CPA patients who were transferred to two tertiary emergency medical centers. On arrival, rSO2 sensor was attached to the forehead of patients, and...

Purpose: Nutritional biochemical indexes are generally used as markers for critically ill patients. However, they are easily influenced by acute phase changes after injury and are difficult to use as common and practical biomarkers. The objective of this study was to determine the most valuable prognostic markers among 15 common laboratory tests i...

The prevention and control of methicillin-resistant Staphylococcus aureus (MRSA) is an important practice, particularly in emergency units. The active surveillance of MRSA was prospectively performed at the emergency medical center (EMC) in Nagasaki University Hospital. After obtaining nasal swab specimens, a fully automated molecular test (FAMT) a...

Neutrophils work as the frontline of defense against infections and neutrophil extracellular traps (NETs) are one of the immune systems to suppress dissemination of infection by the netted chromatin decorated with antibacterial molecules. It was reported that NETs play an important role in various kinds of infections such as pneumonia. However, the...

Neutrophil extracellular traps (NETs) are fibrous structures that are produced extracellularly from activated neutrophil. They can trap and kill various pathogens, and their release is one of the first lines of immune system. Meanwhile, recently it was reported that NETs also exert adverse effects in inflammatory diseases. Acute respiratory distres...

The gut is an important target organ after severe insult. Gut microbiota have an important role in immune response. However, the gut microbiota and environment have not been clarified in patients with burns. Therefore, we serially evaluated the gut microbiota and environment in patients with major burns. Fecal samples from five patients with major...

Neutrophil extracellular traps (NETs), a newly identified immune mechanism, are induced by inflammatory stimuli. Modification by citrullination of histone H3 is thought to be involved in the in vitro formation of NETs. The purposes of this study were to evaluate whether NETs and citrullinated histone H3 (Cit-H3) are present in the bloodstream of cr...

AimWe aimed to create a system for monitoring of regional cerebral oxygen saturation (rSO2) in patients with prehospital cardiopulmonary arrest and clarify the changes in rSO2 during cardiopulmonary resuscitation.Methods We measured rSO2 in cardiopulmonary arrest patients who were transferred by the emergency response vehicle of Nagasaki University...

Background Although foreign body airway obstruction (FBAO) accounts for many preventable unintentional accidents, little is known about the epidemiology of FBAO patients and the effect of forceps use on those patients. This study aimed to assess characteristics of FBAO patients transported to hospitals by emergency medical service (EMS) personnel,...

Background: The aim of this study was to identify whether diastolic dysfunction predicts in-hospital death in ischemic stroke patients with atrial fibrillation. Method: We retrospectively analyzed data from enrolled patients with ischemic stroke patients with atrial fibrillation who presented within 24h of onset. All patients underwent transthor...

AimAlthough advanced treatments are provided to improve outcomes after out-of-hospital ventricular fibrillation, including shock-resistant ventricular fibrillation, the actual treatments in clinical settings have been insufficiently investigated. The aim of the current study is to describe the actual treatments carried out for out-of-hospital ventr...

Neutrophil extracellular traps (NETs) are structures composed of DNA and granular proteins, which rapidly trap and kill pathogens. The formation of NETs has been detected during infection in animal experiments, but their role in humans is unclear. The purposes of this study were to quantitatively evaluate the production of NETs during acute respira...

Background: The aim of this study is to identify whether diastolic dysfunction predicts 90-day mortality and develop and validate a risk score model using information available at hospital presentation in ischemic stroke or transient ischemic attack (TIA) patients Methods: Consecutive ischemic stroke or TIA patients within 48 hours of onset were en...

AimTreatment of severe traumatic brain injury is aided by better prediction of outcomes. The purpose of the present study was to develop and validate a prediction model using retrospective analysis of prospectively collected clinical data from two tertiary critical care medical centers in Japan. Methods Data were collected from 253 patients with a...

Stroke is difficult to diagnose when consciousness is disturbed. However few reports have discussed the clinical predictors of stroke in out-of-hospital emergency settings. This study aims to evaluate the association between initial systolic blood pressure (SBP) value measured by emergency medical service (EMS) and diagnosis of stroke among impaire...

Protein metabolism is important in healing wounds, supporting immune function, and maintaining lean body mass. Determination of adequate requirements of amino acids has not been thoroughly clarified in critically ill patients. The purpose of this study was to evaluate 23 plasma amino acids in patients with sepsis and determine prognostic factors. T...

Introduction: Excessive stress against body induces oxidative stress, which has been reported to have a relationship with some kind of diseases and organ failure. However, the roles of oxidative stress in critically ill patients remain to be elucidated. Methods: Consecutive 248 patients who were transported to our emergency department by the ambula...

The mechanisms accounting for the development of tissue damage following traumatic brain injury (TBI) have been studied for several decades. A variety of mediators, such as vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9), which play a crucial role in edema formation after TBI, have been identified. We experienced a...

Electrocardiogram-gated imaging combined with multi-detector row computed tomography (MDCT) has reduced cardiac motion artifacts, but it was not practical in the emergency setting. The purpose of this study was to evaluate the ability of a high-pitch, 128-slice dual-source CT (DSCT) scanner to reduce motion artifacts in patients admitted to the eme...

Delayed rupture is well-known as a severe complication after splenic injury treated with nonoperative management (NOM). The incidence and timing of splenic pseudoaneurysm (SPA) formation, which is a cause of delayed rupture following splenic injury, have not been thoroughly investigated, and the timing of follow-up computed tomography (CT) is contr...

Introduction Whole-body computed tomography (CT) has gained importance in the early diagnostic phase of trauma care. However, the diagnostic value of CT for seriously injured patients is not thoroughly clarified. This study assessed whether preoperative CT beneficially affected survival of patients with blunt trauma who required emergency bleeding...

Background: We aimed to evaluate the validity of duplex ultrasonography (DUS) using a microconvex array transducer (MAT) with enhanced flow imaging (EFI) for visualization of the distal, internal carotid artery (ICA) and the accurate assessment of ICA stenosis. Methods: Patients who underwent both DUS and digital subtraction angiography (DSA) we...

Neutrophils are able to form 'neutrophil extracellular traps' (NETs), which they use to trap and kill pathogens such as bacteria and fungi at the foci of infection. This observational study investigated the presence of NETs in the blood from critically ill patients and healthy volunteers. Fluorescent triple-colour immunocytochemical analysis of blo...

Background: The aim of this study is to identify whether diastolic dysfunction predicts in-hospital death in stroke and transient ischemic attack (TIA) patients with atrial fibrillation. Method: Consecutive ischemic stroke patients within 24 hours of onset were analyzed. Then, we enrolled stroke and TIA patients with atrial fibrillation. All patien...

Background and purpose: Artery-to-artery embolism generally occurs in patients with not only moderate to severe arterial stenosis but also plaque vulnerability. Two unique cases with free-floating thrombi at the distal side of the small plaque in the internal carotid artery without stenosis are presented and its clinical implications are discussed...

The gut is an important target organ for stress caused by severe insults such as sepsis, trauma, burn, shock, bleeding and infection. Severe insult to the gut is considered to have an important role in promoting infectious complications and multiple organ dysfunction syndrome. These are sequelae of interactions between deteriorated intestinal epith...

Introduction We have reported that altered gut flora is associated with septic complications and eventual death in critically ill patients with systemic inflammatory response syndrome. It is unclear how fecal pH affects these patients. We sought to determine whether fecal pH can be used as an assessment tool for the clinical course of critically il...

抄録 【背景と目的】我々は前回の報告で主に4列のMultidetector-row CT（MDCT）による鈍的頭頸部血管損傷のスクリーニング検査を施行し，その有用性と限界を明らかにした。本研究の目的は，64列MDCTによるスクリーニング検査としての有用性を明らかにすることである。【方法】対象は2007年から2010年までに当センターのMDCT angiography（MDCTA）施行基準を満たした鈍的頭頸部顔面外傷163例とした。MDCTAで陽性所見のないものは，原則それ以上の検査は施行せず経過観察した。陽性所見を認める症例で血管損傷が確定できないものについてはCA（conventional angiography）を施行した。これによりMDCTAの陽性的中率を求めた。また血管損傷の検出率を...

OBJECTIVES: We evaluated the utility of black-blood double inversion recovery magnetic resonance imaging (BBDIR-MRI) for depiction of the intracranial branch atheromatous disease caused by occlusion at the vessel orifices of lager-caliber penetrating arteries. METHODS: BBDIR-MRI was performed on 15 consecutive patients with acute cerebral infarcts...

Objective: A real-time polymerase chain reaction (PCR) test is expected for early and precise detection of pathogens in blood. In this study, we compared the ability of the PCR test and blood culture to detect pathogens in the blood of patients with sepsis. Methods: Patients who were diagnosed as or suspected of having sepsis were included in this...

Background: Although it has been reported that dispatcher-assisted bystander CPR contributes to increasing survival from out-of-hospital cardiac arrest (OHCA), the association between actual implementation of CPR by bystanders and the type of dispatcher instruction has not been sufficiently examined. Objectives: To investigate the association betwe...

Healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) infection in intensive care unit (ICU) patients prolongs ICU stay and causes high mortality. Predicting HA-MRSA infection on admission can strengthen precautions against MRSA transmission. This study aimed to clarify the risk factors for HA-MRSA infection in an ICU from dat...

To determine the most important indicators of prognosis in patients with return of spontaneous circulation (ROSC) following out-of-hospital cardiopulmonary arrest (OHCA) and to develop a best outcome prediction model. All patients were prospectively recorded based on the Utstein Style in Osaka over a period of 3 years (2005-2007). Criteria for incl...

Healthcare-associated infection by meticillin-resistant Staphylococcus aureus (MRSA) is still a great concern in an intensive care unit (ICU). Our surveillance data in the ICU revealed that intubated patients were at eight times higher risk of acquiring MRSA than non-intubated patients, so we hypothesised that pre-emptive contact precautions for al...

Cross-talk between the coagulation system and inflammatory reactions during sepsis causes organ damage followed by multiple organ dysfunction syndrome or even death. Therefore, anticoagulant therapies have been expected to be beneficial in the treatment of severe sepsis. Recombinant human soluble thrombomodulin (rhTM) binds to thrombin to inactivat...

Despite the use of animal models to study post-cardiac-arrest resuscitation, the effects of hypothermia on physiological circulatory parameters are still not fully understood. In this study, using a gerbil model of global ischaemia/reperfusion, we aimed to assess the effects of hypothermia on physiological parameters and evaluated the optimal timin...

The gut is an important target organ for injury after severe insult, and resolution of feeding intolerance is crucial for critically ill patients. We investigated gut flora and motility to evaluate the impact of gastrointestinal dysmotility on septic complications in patients with severe systemic inflammatory response syndrome (SIRS). Sixty-three I...

Although early shock with an automated external defibrillator (AED) is one of the several key elements to save out-of-hospital cardiac arrest (OHCA) victims, it is not always easy to find and retrieve a nearby AED in emergency settings. We developed a cell phone web system, the Mobile AED Map, displaying nearby AEDs located anywhere. The simulation...

The gut is an important target organ of injury during critically ill conditions. Although Gram staining is a common and quick method for identifying bacteria, its clinical application has not been fully evaluated in critically ill conditions. This study's aims were to identify patterns of Gram-stained fecal flora and compare them to cultured bacter...

Gut under severe insult is considered to have an important role in promoting infection and multiple organ dysfunction syndrome from the viewpoint of altered intestinal epithelium, immune system and commensal bacteria. There are few reports, however, about the relationship between gut flora and septic complications. We analyzed gut flora in patients...