Publications by authors named "Hitoshi Kikuchi"

Article Synopsis
  • The study examined chest CT findings in patients with severe acute respiratory distress syndrome (ARDS) undergoing veno-venous extracorporeal membrane oxygenation (V-V ECMO) across 24 hospitals in Japan.
  • Among 582 patients who had chest CT at V-V ECMO initiation, traction bronchiectasis and subcutaneous emphysema were associated with increased 90-day mortality, while patients with traction bronchiectasis were less likely to be successfully liberated from ECMO.
  • The findings suggest that certain chest CT features can provide important prognostic information and may be useful for predicting outcomes in severe ARDS patients on V-V ECMO.
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  • The WHO recommends focusing on specific outcomes like oxygen use and mechanical ventilation to assess COVID-19 vaccine effectiveness (VE), especially post-Omicron, due to variability in hospitalization data.
  • A study in Japan examined VE among 2125 individuals during the Delta and early Omicron periods, finding that 2 doses provided strong protection during Delta, while 3 doses were effective during Omicron.
  • Results showed high VE for both variants, particularly for severe outcomes, highlighting the importance of booster shots in maintaining protection against severe COVID-19 disease.
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  • * Conducted in 20 ICUs across Japan, this randomised controlled trial will compare outcomes for two groups of patients: one with high PEEP settings and another with low PEEP settings (5 cmHO), with a total of 210 participants expected.
  • * The main goal is to measure ECMO-free days by day 28, alongside secondary outcomes like mortality rates and ICU stay length, with ethical
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Introduction: Cardiac arrest is a critical condition, and patients often experience postcardiac arrest syndrome (PCAS) even after the return of spontaneous circulation (ROSC). Administering a restricted amount of oxygen in the early phase after ROSC has been suggested as a potential therapy for PCAS; however, the optimal target for arterial partial pressure of oxygen or peripheral oxygen saturation (SpO) to safely and effectively reduce oxygen remains unclear. Therefore, we aimed to validate the efficacy of restricted oxygen treatment with 94%-95% of the target SpO during the initial 12 hours after ROSC for patients with PCAS.

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MenACYW-TT is a quadrivalent meningococcal tetanus toxoid-conjugate vaccine designed to prevent invasive meningococcal disease. The primary objective of this study was to demonstrate non-inferiority of the vaccine seroresponse to a single dose of MenACYW-TT compared with MCV4-DT, a licensed meningococcal quadrivalent diphtheria-conjugate vaccine. This Phase III double-blind, multicenter trial was conducted in meningococcal vaccine-naïve individuals aged 2-55 years in Japan (NCT04368429; jRCT2080225192).

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  • A clinical trial was conducted to test the efficacy and safety of ultrahigh-dose methylcobalamin in patients with ALS diagnosed within a year of onset, indicating a need for better treatments given the limited effectiveness of current drugs.
  • The study was multicenter, double-blind, and placebo-controlled, enrolling 130 patients from Japan, who received either the methylcobalamin treatment or a placebo for 16 weeks.
  • The main outcome measured was the change in the Revised ALS Functional Rating Scale score, with results showing a significant number of patients observed completing the trial, highlighting the continued investigation into the drug's potential benefits for ALS.
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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock.

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Article Synopsis
  • - The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020) were developed to help healthcare professionals effectively treat sepsis and septic shock, building on the previous guidelines from 2016.
  • - The guidelines cover 22 areas including important new topics such as patient-centered care and ICU-acquired weakness, and detail 118 clinical questions that address various aspects of sepsis management.
  • - In creating these guidelines, a diverse group of 226 medical professionals used the GRADE method for recommendations, resulting in 79 GRADE-based recommendations and 5 Good Practice Statements.
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Introduction: Table tennis is a popular sport worldwide. However, no study has examined whether it is an effective exercise for patients with Parkinson's disease (PD). The efficacy and safety of table tennis exercise for PD patients was examined.

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Aim: Type IV collagen 7S (T4C7S) is a valuable biomarker for detecting liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). The conventional T4C7S measurement via radioimmunoassay (T4C7S RIA) has shortcomings of radioisotope usage and longer assay periods. We compared T4C7S RIA with a newly developed, fast T4C7S chemiluminescent enzyme immunoassay (T4C7S CLEIA) and examined the diagnostic accuracies of and correlation between the two techniques.

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Aim Of The Study: Postural deformities are common in Parkinson's disease (PD) patients. Several treatment options have been reported, but responses to these treatments appear unpredictable. Istradefylline is a novel drug for PD.

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  • Rhabdomyolysis is a serious condition that can cause acute kidney injury, with various traumatic and non-traumatic causes identified.
  • A case study reported a patient whose rhabdomyolysis and kidney issues were due to bilateral iliopsoas hematoma, linked to poorly controlled atrial fibrillation and not a high-energy injury.
  • Rapidly reversing warfarin treatment improved the patient's condition, highlighting the need for careful monitoring of elderly patients on anticoagulants during events like falls.
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Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects the upper and lower motor neurons. Currently, only riluzole and edaravone are approved as drugs to treat ALS and new agents with larger effect sizes are warranted. Exploratory analyses in our previous study (study ID #E0302-J081-761) have suggested that high-dose methylcobalamin (E0302) prolonged the overall survival of ALS patients and suppressed ALS progression in patients with a disease duration of less than 12 months.

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Objectives: The effectiveness of Japanese helicopter emergency medical services (HEMS) and interventions at the scene is not clear as regard children. For effective use of HEMS at the clinical scene, we need to clarify the characteristics of pediatric patients cared for by HEMS. Therefore, the objective of this study was to describe the characteristics of pediatric scene flights and to describe the procedures performed on the patients.

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In recent years, both the number of Japanese travelers to foreign countries and foreign travelers who visit Japan have increased remarkably, and the risk of travelers suffering various infectious diseases is also increasing. In many western countries travel clinics commonly perform medical consultations, vaccinations, and issue prescriptions. However, travel clinics are not yet popular in Japan.

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Meningococcal disease can cause significant disability and mortality. The quadrivalent meningococcal polysaccharide diphtheria toxoid conjugate vaccine (Men-ACWY-D) protects against invasive meningococcal disease caused by serogroups A, C, W, and Y. This phase III, open-label, single-arm, multicenter study evaluated the safety and immunogenicity of a single vaccine dose in healthy Japanese adults.

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Background: Although typhoid fever is rare in Japan, imported cases have been reported occasionally in travelers returning from endemic areas. To achieve licensing of a typhoid Vi polysaccharide vaccine (Typhim Vi(®)) and make it widely available in Japan, this study was conducted at the request of the Japanese Ministry of Health Labor and Welfare to assess the immunogenicity and safety of this vaccine when given as a single dose (the recommended schedule of administration) in a Japanese population.

Methods: In this multi-center, open-label, non-comparative, intervention study performed in Japan, 200 healthy volunteers (188 adults [≥ 18 years of age], 7 adolescents [12-17 years of age] and 5 children [2-11 years of age]) were administered Typhim Vi(®).

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Background: Although midazolam is widely used during endoscopic procedures by endoscopists, propofol has been recently favored for its rapid action and metabolism. The aim of this study is to compare the clinical advantages between propofol and midazolam use during screening esophagogastroduodenoscopy (EGD) for gastric cancer and post-procedure management at a medical clinic.

Methods: One hundred six healthy patients aged 20-69 years requesting sedation for screening EGD from October 2012 to May 2013 at a single clinic in Japan were randomly assigned to propofol (n = 54) or midazolam (n = 52).

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We investigated the mechanisms underlying abnormal vascular endothelial growth factor (VEGF) production in amyotrophic lateral sclerosis (ALS). We immunohistochemically studied VEGF, its receptors VEGFR1 and 2, and hypoxia-inducible factor-1α (HIF-1α) in autopsied ALS spinal cords. We also chronologically assessed the expression of HIF-1α, karyopherin β1, karyopherin β-cargo protein complex inhibitors and nuclear pore complex proteins in G93A mutant superoxide dismutase 1 (mSOD1) transgenic mice at presymptomatic, symptomatic and end stages.

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We studied the effects of G-CSF on microglial reactions in mutant SOD1 (mSOD1)-Tg (G93A) ALS model mice. Following hypoglossal axotomy, the numbers of neurons and microglia expressing GDNF were significantly lower in mSOD1-Tg mice than in non-transgenic (NTG) littermates. This decrease in the number of neurons after axotomy and a decrease in the number of large myelinated axons in mSOD1-Tg mice over the disease course were improved by G-CSF, which also increased microglial recruitment.

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Background: Although travelers' diarrhea is one of the most common health problems among international travelers, current findings depend largely on hospital and clinic-based information. To better understand the disease epidemiology and to identify specific subpopulations with increased risks, denominator data covering a large traveler population are needed.

Methods: We conducted a questionnaire survey of all travelers at the quarantine station, Narita International Airport, and retrospectively reviewed records from January 2001 to December 2005.

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We measured the levels of 27 cytokines/chemokines and growth factors in cerebrospinal fluid (CSF) from 42 patients with sporadic amyotrophic lateral sclerosis (ALS), 12 patients with lower motor neuron disease (LMND), and 34 control patients with non-inflammatory neurological diseases (OND), using a multiplexed fluorescent bead-based immunoassay. Among cytokines/chemokines elevated in ALS, CCL2 and CXCL8 levels were negatively correlated with the revised ALS functional rating scale (ALSFRS-R) score, while CCL4 showed a positive correlation with ALSFRS-R score. CCL4 and CXCL10 showed negative correlations with disease progression rate.

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Mutations in the fused in sarcoma gene (FUS) were recently found in patients with familial amyotrophic lateral sclerosis (ALS). The present study aimed to clarify unique features of familial ALS caused by FUS mutation in the Japanese population. We carried out clinical, neuropathological, and genetic studies on a large Japanese pedigree with familial ALS.

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Focal cortical dysplasia (FCD) is of increasing interest as a cause of focal epilepsy. We aimed to determine whether the existence of FCD influences the epileptogenicity induced by electrical kindling stimulation of the cortices. We created an FCD rat model by focal contact of a frozen metal probe on the scalp immediately after birth.

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Synopsis of recent research by authors named "Hitoshi Kikuchi"

  • - Hitoshi Kikuchi’s recent research primarily focuses on critical care topics, particularly severe acute respiratory distress syndrome (ARDS) and the effectiveness of medical interventions like extracorporeal membrane oxygenation (ECMO) and oxygen therapy following cardiac arrest.
  • - A significant portion of his studies involves multicenter trials, evaluating the association between clinical findings in chest CT scans and patient outcomes, as well as examining the effectiveness of COVID-19 vaccines during different pandemic waves in Japan.
  • - Kikuchi has also explored vaccine immunogenicity, the safety of specific treatments for amyotrophic lateral sclerosis (ALS), and innovative diagnostic approaches for liver diseases, reflecting a diverse portfolio aimed at improving patient outcomes in acute and chronic health crises.

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