研究者総覧

多賀 直行 (タガ ナオユキ)

  • 小児集中治療部 准教授
Last Updated :2021/12/08

研究者情報

学位

  • 医学博士(岡山大学)

ホームページURL

J-Global ID

研究キーワード

  • 脊髄くも膜下麻酔   LPS   COヘモグロビン   全身麻酔   遺伝子多型   呼気一酸化炭素   敗血症   

研究分野

  • ライフサイエンス / 麻酔科学 / 小児麻酔・心臓血管麻酔
  • ライフサイエンス / 麻酔科学 / 集中治療医学・小児集中治療

経歴

  • 2005年01月 - 現在  自治医科大学とちぎ子ども医療センター小児手術・集中治療部准教授
  • 2002年07月 - 2004年12月  岡山大学助手

学歴

  • 1988年04月 - 1992年03月   岡山大学大学院   医学研究科   麻酔・蘇生学
  • 1982年04月 - 1988年03月   岡山大学   医学部   医学科

研究活動情報

論文

  • Yasunori Niwa, Soichiro Inoue, Fumito Nakamura, Naoyuki Taga, Mamoru Takeuchi, Hiroaki Konishi
    Japanese Journal of Anesthesiology 62 7 855 - 858 2013年07月 [査読有り][通常論文]
     
    Rad-87® and RRa® are new acoustic monitoring devices which can monitor the respiratory rate. To our knowledge, no studies have reported the RRa® sensor used in pediatric patients after surgery. We succeeded in measuring the respiratory rate with the RRa® sensor in the Pediatric Intensive Care Unit (PICU). A 10-year-old boy, 14.5 kg in weight and 119.6 cm in height, with cerebral palsy, mental retardation, epilepsy, and obstructive sleep apnea due to adenoidal and tonsillar hypertrophy, was scheduled for adenotonsillectomy under general anesthesia. Anesthesia was maintained with oxygen, air, sevoflurane (1.5-2.0%), remifentanil (0.1 to 0.5 μg · kg-1 μg min-1), and fentanyl (4 μg · kg -1). The operating time was 55 minutes, and the duration of anesthesia was 133 minutes. After finishing the surgery, we attached the RRa® sensor to his anterior neck and monitored his respiratory rate. Furthermore, RRa® could count his respiratory rate, during transfer from the operating room to PICU. The patient was sedated with dexmedetomidine (0.28 μg · kg-1 · min-1) at PICU, and his respiratory rate was accurately measured with the RRa® sensor. We hope that Rad-87and RRa® sensors will become useful for measuring the respiratory rate in pediatric patients in the future.
  • Yuichiro Toda, Mamoru Takeuchi, Naoyuki Taga, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Kiyoshi Morita
    Japanese Journal of Anesthesiology 61 12 1312 - 1315 2012年12月 [査読有り][通常論文]
     
    Background : There are limited data about the correlations between amount of anesthetics and variations in vital signs during pediatric cardiac catheterization. Methods : Data in 80 children with congenital heart disease undergoing cardiac catheterization with/without interventional cardiology in 2004 were examined in this retrospective cohort study. Data on blood pressure, heart rate, oxygen saturation, partial tension in end tidal carbon dioxide (PETCO2), and total amount of anesthetics given during general anesthesia were obtained from anesthetic charts. The correlations between amount of anesthetics and those vital signs were analyzed. Results : Median age of the patients was 14 months and median body weight was 8.8 kg. Median rates of variation in heart rate, blood pressure, oxygen saturation and PETCO2 were 22.8%, 29.3%, 5.9% and 10.8%, respectively. Although there were no statistical correlations between those vital signs and amounts of anesthetics such as fentanyl, vecuronium and sevoflurane, rates of variation in heart rate was smaller in patients for whom the amount of fentanyl given was more than 4 μg·kg-1·hr-1. Conclusions : There were no associations between amount of anesthetics and variations in vital signs in pediatric cardiac catheterization.
  • Nobuhiro Shimada, Yoshihiro Hirabayashi, Naoyuki Taga, Mamoru Takeuchi, Norimasa Seo
    Japanese Journal of Anesthesiology 60 2 168 - 172 2011年02月 [査読有り][通常論文]
     
    Background: The aim of the present study was to evaluate the suitability of Airtraq optical laryngoscope for the tracheal intubation in children. Methods: Endotracheal intubation was performed using the Airtraq optical laryngoscope in 100 pediatric patients undergoing general anesthesia. The time to complete tracheal intubation and optimizing procedures were recorded. Results: The Airtraq optical laryngoscope allowed visualization of the glottis and successful intubation in the 100 patients, including three patients with difficult airway. Utilization of a gum elastic bougie was helpful to introduce a tube tip to the trachea. Conclusions: The Airtraq optical laryngoscope might be an alternative apparatus for endotracheal intubation in pediatric patients.
  • Takako Shinohara, Naoyuki Taga, Yoshihiro Hirabayashi, Norimasa Seo
    Japanese Journal of Anesthesiology 60 2 186 - 188 2011年02月 [査読有り][通常論文]
     
    A Forestier's disease patient was scheduled for endoscopic mucosal resection under general anesthesia, because of his hypoxic episode during gastric endoscopy. Endotracheal intubation was planned while awake, because he was suspected as a case of difficult airway. By using AWS, we could easily confirm his larynx and aditus of trachea in spite of his narrow pharynx caused by Forestier's disease. The procedure was successful with no complications. AWS seems to be a useful device for endotracheal intubation in Forestier's disease.
  • Tateishi A, Kawada M, Morita H, Takeuchi M, Taga N, Otsuka Y, Okada O, Kataoka K
    General thoracic and cardiovascular surgery 58 633 - 635 12 2010年12月 [査読有り][通常論文]
  • Rui Kono, Naoyuki Taga, Osamu Okada, Yoji Otsuka, Yuki Sato, Mamoru Takeuchi, Norimasa Seo
    Japanese Journal of Anesthesiology 59 10 1284 - 1286 2010年10月 [査読有り][通常論文]
     
    Helmet is a new device of non-invasive continuous positive airway pressure (CPAP). Few cases have been described about usage of the helmet in children. We describe successful treatment of a child with respiratory distress using the helmet-delivered non-invasive CPAP. A 2-month-old male infant (3.1 kg) with multiple anomalies (cardiovascular, facial, and vertebral) developed respiratory distress after extubation. The helmet was well tolerated regardless of facial anomaly. Helmet CPAP started at initial settings of CPAP 8 cm H2O and FIO2 0.7, improved oxygenation. PaO2/FIO2 ratio increased from 106 to 316, and chest X-rays showed a marked improvement (15 hour after NPPV initiation). The helmet offers important advantage : the possibility of fitting to any children, regardless of any facial or external anomalies.
  • Atsushi Tateishi, Masaaki Kawada, Mamoru Takeuchi, Naoyuki Taga, Yoji Otsuka, Koichi Kataoka
    Asian Cardiovascular and Thoracic Annals 18 3 250 - 252 2010年06月 [査読有り][通常論文]
     
    Surgical exposure and accurate closure of a ventricular septal defect with a membranous septal aneurysm beneath the septal tricuspid leaflet carries a risk of tricuspid valve dehiscence and conduction disturbances when the septal leaflet is detached along the tricuspid annulus. To avoid these problems, we use a radial incision to expose and close perimembranous ventricular septal defects. We reviewed recent cases to determine the risks and benefits of this technique. From January 2005 through September 2008, 30 patients underwent closure of a perimembranous ventricular septal defect through a right atrial approach at our institution. The operation included radial incision of the membranous septal aneurysm to improve visualization of the perimembranous ventricular septal defect in 9 patients. There was no perioperative or late death. The operative and postoperative courses were uneventful in all cases. A residual leak was detected in only one patient. No patient had more than mild postoperative tricuspid valve insufficiency, none underwent reoperation, and no new arrhythmia or conduction disturbance was detected during follow-up. The radial incision for closure of a ventricular septal defect with a membranous septal aneurysm provides satisfactory exposure of the defect through the right atriotomy, for safe and accurate closure. © 2010 SAGE Publications.
  • Yoji Otsuka, Yoshihiro Hirabayashi, Osamu Okada, Yuki Sato, Naoyuki Taga, Mamoru Takeuchi
    Japanese Journal of Anesthesiology 59 6 696 - 700 2010年06月 [査読有り][通常論文]
     
    Background : The GlideScope® video laryngoscope (Verathon Inc. Bothell, Washington, USA) is a relatively new device for tracheal intubation, which provides a excellent glottic visualization. We here report the clinical experience of the GlideScope® (small) in 50 pediatric patients. Methods : Tracheal intubation with GlideScope® (small) was performed in 50 consecutive pediatric patients requiring orotracheal intubation for surgery. The view of glottic opening was scored according to the classification of Cormack-Lehane. The time required to intubate and the number of intubation attempts were recorded. Results : In all, 50 children included 4 neonates, 8 infants under 1 year and 38 children between 1 year and 9 years. Cormack-Lehane classification 1 or 2 was obtained in 74% and 22%, respectively, and successful intubation was achieved in 48 of 50 children (96%). In remaining two babies, GlideScope® failed to intubate the trachea. The mean±SD time for instrumentation in successful intubation at first attempt was 56.6±34.2 seconds. Conclusions : GlideScope® seemed to be a novel device in pediatric patients. Further studies are required to evaluate the usefulness in neonates, small infants and children with a difficult airway.
  • Yoji Otsuka, Yoshihiro Hirabayashi, Naoyuki Taga, Mamoru Takeuchi, Norimasa Seo
    Japanese Journal of Anesthesiology 59 2 273 - 276 2010年02月 [査読有り][通常論文]
     
    Background : Since the diagnosis procedure combination (DPC) for health insurance plans in Japan was started in medical practice, the number of surgical procedures is increasing at teaching hospitals. Methods : We retrospectively surveyed 8,672 surgical procedures performed at the central surgical unit of the Jichi Medical University Hospital from April 1, 2007 to March 31, 2008. Results : Of the 8,672 surgical procedures, 6,922 operations were performed under the management of anesthesia staffs, and 1,904 procedures (27.5%) were done in emergency situation. Central surgical unit has 14 operating rooms and an estimated maximum number of surgical procedures is 7,700. Conclusions : This survey revealed that the present status of manpower of anesthesiologists at our hospital was insufficient for the work. In particular, the demands for anesthesiologists have increased in emergency operations including major cardiovascular surgery, neurosurgery and liver transplantations.
  • Mamoru Takeuchi, Yoji Otsuka, Naoyuki Taga, Yuki Sato, Hidetaka Iwai, Osamu Okada
    Japanese Journal of Anesthesiology 58 5 578 - 583 2009年05月 [査読有り][通常論文]
     
    We describe the risk management of pediatric anesthesia. The most important risk management of pediatric anesthesia is airway and temperature management. Neonates and infants easily become hypoxic due to their insufficient functional residual capacity. Therefore airway management is most important not only during induction of anesthesia but also during maintenance of anesthesia and extubation. The management of patients' temperature, including control of room temperature should be taken into consideration. In addition, careful attention should be paid not to introduce air bubbles in any lines, especially in patients with congenital heart diseases.

MISC

共同研究・競争的資金等の研究課題

  • 文部科学省:科学研究費補助金(萌芽研究)
    研究期間 : 2003年 -2004年 
    代表者 : 多賀 直行, 森田 潔, 赤木 玲子, 高橋 徹
     
    近年、敗血症(Sepsis)の病態や予後に炎症性メディエーターの遺伝子多型が関与するのではないかとの報告が相次ぎ、注目を集めている。Toll-like receptor 4(TLR4)は最近発見されたLPS受容体でLPSに対する生体の反応性に重要な役割を果たしている。昨年ヒトのTLR4に遺伝子多型が存在し、LPSに対する生体感受性に関与する可能性が報告された。ヘム分解の律速酵素であるヘムオキシゲナーゼ(HO)はストレス蛋白の1種でその発現にTLR4が関与することが示唆されている。本研究ではTLR4の遺伝子多型がSepsisの予後に及ぼす影響を明らかにする第1段階として、全身麻酔、あるいは脊髄くも膜下麻酔を受ける外科手術患者を対象に、HOによるヘム分解反応により体内で生成される一酸化炭素(CO)を動脈血中COヘモグロビンレベルと呼気COレベルで検知し、その周術期における変化を検討した。その結果、呼気COレベル、動脈血中COヘモグロビンレベルはともに術前値にくらべて術後1日目には有意な高値を示すことが明らかとなった。一方、全身麻酔群と脊髄くも膜下麻酔群の比較ではいずれの値も有意差が認められなかった。この結果は、全身麻酔による肺への侵襲より、むしろ外科侵襲による全身性の炎症反応が酸化的ストレスを引き起こし、HOを細胞内に誘導し呼気COレベルの増加につながったことを示唆している。この結果はTLR-4の遺伝子多型研究につながる画期的成果である。


Copyright © MEDIA FUSION Co.,Ltd. All rights reserved.