Publications by authors named "Kiyoshi Moriyama"

The increase in the incidence of antibiotic-resistant bacteria poses a global public health threat. According to a 2019 WHO report, approximately 1.27 million deaths were attributed to antibiotic-resistant bacteria, with many cases linked to specific bacterial species, such as drug-resistant Pseudomonas aeruginosa and Staphylococcus aureus.

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Background: Despite advancements in ultrasonography, locating peripheral veins for catheter placement remains a challenge in patients with altered anatomy owing to multiple surgeries. Herein, we highlight the potential of using the radial vein as an alternative site for ultrasound-guided peripheral venous catheterization.

Case Presentation: We present two cases of patients with extensive surgical histories, including multiple abdominal surgeries, leading to difficult peripheral venous access.

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The right ascending lumbar vein is difficult to detect on anteroposterior abdominal radiographs because it overlaps with the inferior vena cava on anteroposterior radiographs. Intensive observation by medical providers may be a cue for diagnosis. However, knowledge of catheter misplacement of the right ascending lumbar vein is also necessary, because misplacement cannot be suspected without that awareness.

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Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare peripheral neurological disorder that manifests with increased sensitivity to pressure. In people with this disorder, the peripheral nerves are unusually sensitive to pressure. Minor trauma or compression causing paralysis in the extremities is a hallmark of this disorder.

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The respiratory disorder is classified into three types, "obstructive lung disease", "restrictive lung disease", and "mixed obstructive and restrictive lung disease". Chronic obstructive pulmonary disease (COPD) and bronchial asthma were represented by obstructive lung disease and the number of each patients was estimated over 5 millions. These are a condition commonly presented in older people who undergoing cardiovascular surgery and confers an increased risk of postoperative complications and mortality.

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Article Synopsis
  • Ultrasound-guided central venous catheterization is a common procedure, but mechanical complications can still occur.
  • An 85-year-old woman underwent procedure for difficult venous access, but the guidewire was misplaced, leading to the catheter being incorrectly inserted into the right subclavian artery instead of the internal jugular vein.
  • The case highlights the importance of accurately locating the guidewire during the procedure, suggesting that the needle insertion site should be positioned away from the clavicle to avoid complications.
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An effective vaccine against would benefit people susceptible to severe infection. Vaccination targeting V antigen (PcrV) of the type III secretion system is a potential prophylactic strategy for reducing -induced acute lung injury and acute mortality. We created a recombinant protein (designated POmT) comprising three antigens: full-length PcrV (PcrV), the outer membrane domain (#190-342) of OprF (OprF), and a non-catalytic mutant of the carboxyl domain (#406-613) of exotoxin A (mToxA).

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Article Synopsis
  • The study aimed to compare the effectiveness of near-infrared venous imaging versus ultrasound guidance for novice medical students trying to access difficult peripheral veins, particularly in obese patients.
  • It involved 41 medical students who attempted simulated venous access using both methods after basic training, measuring first-time success rates, procedure times, and proficiency in multiple attempts.
  • Results showed that while the first-time success rate was similar for both methods (near-infrared at 70% and ultrasound at 65%), near-infrared imaging significantly reduced procedure time, making it faster for initial attempts (14 seconds vs. 46 seconds for ultrasound).
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A case involving a 50-year-old woman (height, 155 cm; weight, 79.6 kg), who was undergoing home oxygen therapy (3.5 L/min), with an oxygen saturation (SpO) of approximately 91% due to pulmonary artery hypertension (PAH) with mixed connective tissue disease, is reported.

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We have implemented several preventive measures to reduce central line-associated bloodstream infection (CLABSI) in the general intensive care unit (ICU) of a university hospital in Japan. Here, we analyzed the factors associated with CLABSI in patients with central venous catheter (CVC) insertions and evaluated the effects of our implemented preventive measures. From July 2013 to June 2018, data was collected from the medical records of 1472 patients with 1635 CVC insertions, including age, sex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, duration of ICU stay, duration of catheter insertion, insertion site, and mechanical ventilation status.

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Article Synopsis
  • An obturator nerve block (ONB) can lead to serious complications, such as hematoma, although reports of these events are rare.
  • A case was reported involving a 95-year-old female who experienced massive bleeding and a large hematoma after an ONB performed using the landmark method during surgery.
  • To prevent complications like this, it’s crucial to be cautious and avoid puncturing the obturator artery by advancing the needle too deep during the procedure.
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Perioperative complications have been reported to be associated with a lower incidence of cancer-free survival. Perioperative atrial fibrillation (POAF) is one of occasionally observed complications in patients with malignancies who undergo noncardiac surgeries. However, the long-term clinical impact of POAF on those with malignancies have remained unknown.

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Massive leaks in the anesthesia circuit may cause intraoperative hypoventilation and awareness; we experienced this with a disposable CO2 absorber in Perseus A500, which uses turbine ventilation to create positive-pressure ventilation. Consequently, manual ventilation was rendered impossible. During prolonged surgeries, CO2 absorbers may be replaced by a new one.

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The V-antigen, a virulence-associated protein, was first identified in Yersinia pestis more than half a century ago. Since then, other V-antigen homologs and orthologs have been discovered and are now considered as critical molecules for the toxic effects mediated by the type III secretion system during infections caused by various pathogenic Gram-negative bacteria. After purifying recombinant V-antigen proteins, including PcrV from Pseudomonas aeruginosa, LcrV from Yersinia, LssV from Photorhabdus luminescens, AcrV from Aeromonas salmonicida, and VcrV from Vibrio parahaemolyticus, we developed an enzyme-linked immunoabsorbent assay to measure titers against each V-antigen in sera collected from 186 adult volunteers.

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Along with the recent spread of multidrug-resistant bacteria, outbreaks of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing bacteria present a serious challenge to clinicians. β-lactam antibiotics are the most frequently used antibacterial agents and ESBLs, and carbapenemases confer resistance not only to carbapenem antibiotics but also to penicillin and cephem antibiotics. The mechanism of β-lactam resistance involves an efflux pump, reduced permeability, altered transpeptidases, and inactivation by β-lactamases.

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In recent years, numerous outbreaks of multidrug-resistant Pseudomonas aeruginosa have been reported across the world. Once an outbreak occurs, besides routinely testing isolates for susceptibility to antimicrobials, it is required to check their virulence genotypes and clonality profiles. Replacing pulsed-field gel electrophoresis DNA fingerprinting are faster, easier-to-use, and less expensive polymerase chain reaction (PCR)-based methods for characterizing hospital isolates.

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The mechanisms underlying the effects of immunoglobulins on bacterial infections are thought to involve bacterial cell lysis via complement activation, phagocytosis via bacterial opsonization, toxin neutralization, and antibody-dependent cell-mediated cytotoxicity. Nevertheless, recent advances in the study of the pathogenicity of Gram-negative bacteria have raised the possibility of an association between immunoglobulin and bacterial toxin secretion. Over time, new toxin secretion systems like the type III secretion system have been discovered in many pathogenic Gram-negative bacteria.

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The secondary in-hospital epidemiological investigation for drug-resistant Pseudomonas aeruginosa infections was conducted to evaluate the in-hospital situation and identify any associations between exoenzyme genotypes and other genotypes and antimicrobial resistance characteristics, at the University Hospital in Kyoto, Japan, following a reported outbreak of antimicrobial-resistant P. aeruginosa ST357 between 2005 and 2014. Twelve of the 546 P.

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Background: Perioperative atrial fibrillation (POAF) in noncardiac surgeries is common. However, it is unclear whether such atrial fibrillation (AF) recurs in the long term.

Methods: This study was a prospective, single-center, observational study that included patients who underwent noncardiac surgeries for malignancies.

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High-flow nasal cannula (HFNC) therapy has been increasingly applied to treat patients with severe hypoxemic respiratory failure. We investigated whether vital signs reflect the reduction of work of breathing in a simulator study and a clinical study. In the simulator study, a standard model high-fidelity human patient simulator (HPS) directly received 35 L/minute of 100% O via the HFNC.

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