Publications by authors named "Atsushi Shiraishi"

Background Timely and effective fluid resuscitation is vital for stabilizing sepsis while avoiding volume overload. We aimed to assess how the administration of a 30 mL/kg bolus fluid affects patients with sepsis within three hours of clinical outcomes. Methods This multicenter observational study included adult patients diagnosed with sepsis in 17 intensive care units at tertiary hospitals in Japan between July 2019 and August 2020.

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  • * A cell line created in the lab displayed changes resembling skin characteristics, showing increased expression of skin-related genes and decreased PAX6 levels, linking this to conditions like dry eye syndrome.
  • * Introducing PAX6 and administering glucocorticoids or serum improved the cell line’s condition by reducing skin gene expression, suggesting potential treatments for conjunctival metaplasia.
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The effectiveness and safety of transcatheter splenic artery embolization (SAE) compared to those of open surgery in patients with blunt splenic injury (BSI) remain unclear. This retrospective cohort-matched study utilized data from the Japan Trauma Data Bank recorded between 2004 and 2019. Patients with BSI who underwent SAE or open surgery were selected.

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Diabetes mellitus is recognized as a major predisposing factor for Moraxella keratitis. However, how diabetes mellitus contributes to Moraxella keratitis remains unclear. In this study, we examined Moraxella keratitis; based on the findings, we investigated the impact of advanced glycation end products (AGEs) deposition in the cornea of individuals with diabetic mellitus on the adhesion of Moraxella isolates to the cornea.

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  • A study investigated the relationship between coagulopathy and patient outcomes in sepsis-induced acute respiratory distress syndrome (ARDS), focusing on which coagulopathy parameters could predict mortality and guide anticoagulant use.
  • The researchers identified specific coagulopathy markers—prothrombin time and platelet count—as significant predictors of in-hospital mortality, with patients with certain coagulopathy types showing worse oxygenation recovery.
  • Findings indicated that anticoagulants positively affected mortality and oxygenation recovery for patients with specific coagulopathy, highlighting the need for tailored treatment approaches in ARDS patients.
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  • - This study investigated the relationship between the severity of contrast extravasation (CE) seen on CT scans and the need for massive transfusions (MT) in children with blunt liver and/or spleen injuries, over a span from 2008 to 2019.
  • - The research included 1,407 pediatric patients, revealing that 14% required MT, and specific types of CE, particularly intraparenchymal and into the peritoneal cavity, significantly correlated with increased transfusion needs.
  • - The findings suggest that recognizing active CE during initial CT scans can guide healthcare providers in making informed decisions about transfusion strategies for young patients with these types of injuries.
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Objective: Blunt cervical vascular injury (BCVI) is a non-penetrating trauma to the carotid and/or vertebral vessels following a direct injury to the neck or by the shearing of the cervical vessels. Despite its potentially life-threatening nature, important clinical features of BCVI such as typical patterns of co-occurring injuries for each trauma mechanism are not well known. To address this knowledge gap, we described the characteristics of patients with BCVI to identify the pattern of co-occurring injuries by common trauma mechanisms.

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Purpose: This study aimed to evaluate the accuracy of the lacrimal syringing test (syringing) in relation to dacryocystography (DCG) and dacryoendoscopy (DE) in lacrimal pathway (LP) obstruction.

Methods: We retrospectively reviewed 101 patients (188 LPs) who underwent syringing, cone-beam computed tomography (CBCT)-DCG, and DE to diagnose the degree and site of LP obstruction. The degree of obstruction was classified into patent, partial obstruction, and complete obstruction.

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Purpose: The aim of this study was to report a case of Peters plus-like syndrome, which revealed to have an 8q21.11 microdeletion by copy number variation analysis using exome data.

Methods: A 6-month-old Japanese boy presented with bilateral corneal opacity since birth.

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Aim: To compare in-hospital mortality of severely injured trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) or aortic cross-clamping (ACC).

Methods: In this multicenter, retrospective cohort study using data from a nationwide trauma registry of tertiary emergency medical centers in Japan ( = 280), trauma patients who underwent aortic occlusion at the emergency department from 2004 to 2019 were divided into two groups according to the treatment they received: patients treated with ACC and patients who underwent placement of a REBOA catheter. Multiple imputations were used to handle the missing data.

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Importance: Differences have been observed in the association of serum urate levels with consumption of different types of alcoholic beverages. However, previous studies have not standardized the unit of intake for ethanol content, and only limited types of alcoholic beverages have been evaluated.

Objective: To examine differences in the association of serum urate levels with various types of alcoholic beverages when their intakes are standardized for ethanol content.

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  • Patients with sepsis who develop disseminated intravascular coagulation (DIC) generally have a poor prognosis, and although anticoagulant therapy is anticipated to improve outcomes, conclusive trial support has been lacking.
  • This study analyzed 1,013 severe sepsis patients from 59 intensive care units in Japan to investigate the effects of DIC scores and prothrombin time-international normalized ratio (PT-INR) on patient outcomes.
  • Results indicated that higher PT-INR levels were linked to worse organ dysfunction and increased in-hospital mortality, but anticoagulant therapy showed potential for better survival outcomes, especially in patients with severe DIC.
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Purpose: To confirm the efficacy and safety of Good Manufacturing Practice (GMP)-compliant autologous cultivated limbal epithelial cell sheets in government-controlled clinical trials that adhered to Good Clinical Practice stipulations for patients with unilateral limbal stem cell deficiency (LSCD).

Design: A prospective, multicenter, open-label, uncontrolled, single-arm clinical trial.

Participants: Ten consecutive eyes of 10 patients with unilateral LSCD were followed for 2 years after surgery.

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Purpose: To compare the intra-device repeatability and inter-device reproducibility between two anterior segment imaging instruments, the CASIA SS-1000 (Tomey Corp., Nagoya, Japan) and Pentacam (OCULUS, Arlington, WA) in measuring anterior segment parameters.

Methods: Single-center, prospective clinical trial.

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Introduction: Trauma activates the innate immune system to modulate hemostasis and minimize the damage caused by physiological bodily responses, including the activation of coagulation. Sufficiently severe trauma overwhelms physiological responses and elicits the systemic inflammatory response syndrome, which leads to the onset of disseminated intravascular coagulation (DIC), characterized by dysregulated inflammatory coagulofibrinolytic responses. Impaired anticoagulant mechanisms, including antithrombin, constitutes the pathology of DIC, while the dynamics of antithrombin and relevance to outcomes in trauma-induced coagulopathy have not been fully elucidated.

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Background: Little guidance exists for the treatment of pseudoaneurysm (PA) following pediatric blunt liver and/or spleen injuries (BLSIs). We aimed to describe the incidence of delayed PA development and the subsequent clinical course of PA in pediatric BLSIs.

Methods: This multicenter retrospective cohort study from Japan included pediatric patients (16 years and younger) who sustained BLSIs from 2008 to 2019.

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Background: Hemodynamic stabilization is a core component in the resuscitation of septic shock. However, the optimal target blood pressure remains debatable. Previous randomized controlled trials suggested that uniformly adopting a target mean arterial pressure (MAP) higher than 65 mmHg for all adult septic shock patients would not be beneficial; however, it has also been proposed that higher target MAP may be beneficial for elderly patients, especially those with arteriosclerosis.

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Purpose: To report the clinical characteristics of 13 cases of noninfectious corneal ulceration related to lacrimal drainage pathway disease.

Methods: Medical records of 13 patients with lacrimal drainage pathway disease-associated keratopathy who were examined at Ehime University Hospital between April 2007 and December 2021 were analyzed.

Results: The predisposing lacrimal drainage pathway diseases for corneal ulceration were chronic dacryocystitis in seven patients and lacrimal canaliculitis in six patients.

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Tranexamic acid (TXA) reduces the risk of bleeding trauma death without altering the need for blood transfusion. We examined the effects of TXA on coagulation and fibrinolysis dynamics and the volume of transfusion during the early stage of trauma. This subanalysis of a prospective multicenter study of severe trauma included 276 patients divided into propensity score-matched groups with and without TXA administration.

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This retrospective observational study analyzed the postoperative outcomes of bicanalicular intubation using different diameters of tube stents for treating postsaccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with postsaccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. Patients intubated with a 1.

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Purpose: The dacryoendoscope is a practical instrument for the examination and the treatment of lacrimal duct obstruction. Nevertheless, as it is a rigid fiberscope, manipulation of the endoscope is somewhat affected by the patient's lacrimal duct alignment and the skeletal structure of the face. The morphology and inclination of the lacrimal duct vary among individuals and ethnic groups.

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Disseminated intravascular coagulation (DIC) is one of the major organ dysfunctions associated with sepsis. This retrospective secondary analysis comprised data from a prospective multicenter study to investigate the age-related differences in the survival benefit of anticoagulant therapy in sepsis according to the DIC diagnostic criteria. Adult patients with severe sepsis based on the Sepsis-2 criteria were enrolled and divided into the following groups: (1) anticoagulant group (patients who received anticoagulant therapy) and (2) non-anticoagulant group (patients who did not receive anticoagulant therapy).

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We report a case of severe irregular corneal astigmatism resulting from delayed diagnosis of suture exposure following blepharoptosis surgery. An 81-year-old man who had bilateral blepharoptosis surgery and two revisions on his right eye before he complained foreign body sensation (FBS) and blurred vision of his right eye. The visual acuity was 0.

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A recent randomised controlled trial failed to demonstrate a beneficial effect of recombinant human thrombomodulin (rhTM) on sepsis. However, there is still controversy in the effects of rhTM for sepsis due to the heterogeneity of the study population. We previously identified patients with a distinct phenotype that could be a potential target of rhTM therapy (rhTM target phenotype).

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