2021/05/15 更新

写真a

ホンダ ヒロユキ
本田 博之
HONNDA Hiroyuki
所属
医歯学総合病院 集中治療部 講師
医歯学総合研究科 生体機能調節医学専攻 講師
職名
講師
外部リンク

学位

  • 博士(医学) ( 2012年3月   新潟大学 )

研究キーワード

  • 人工呼吸管理

  • 神経生理学

  • 集中治療医学

研究分野

  • ライフサイエンス / 救急医学

  • ライフサイエンス / 麻酔科学  / 集中治療医学

経歴(researchmap)

  • 新潟大学医歯学総合病院   集中治療部   副部長

    2013年4月 - 現在

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  • 新潟大学医歯学総合病院   高次救命災害治療センター   助教

    2012年4月 - 2013年3月

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  • 新潟大学医歯学総合病院   高次救命災害治療センター   特任助教

    2010年4月 - 2012年3月

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  • 新潟大学医歯学総合病院   麻酔科

    2006年10月 - 2010年3月

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  • 新潟市民病院   救命救急センター

    2004年10月 - 2006年9月

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  • 新潟県立中央病院   麻酔科

    2003年7月 - 2004年9月

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  • 新潟大学医学部附属病院   麻酔科

    2002年5月 - 2003年6月

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▶ 全件表示

経歴

  • 新潟大学   医歯学総合研究科 医科学専攻   講師

    2013年4月 - 現在

  • 新潟大学   医歯学総合病院 集中治療部   講師

    2013年4月 - 現在

  • 新潟大学   医歯学総合研究科 生体機能調節医学専攻   講師

    2013年4月 - 現在

  • 新潟大学   医歯学総合病院 高次救命災害治療センター   助教

    2012年4月 - 2013年3月

  • 新潟大学   医歯学総合病院 高次救命災害治療センター   特任助教

    2010年4月 - 2012年3月

学歴

  • 新潟大学医歯学総合研究科

    2008年4月 - 2012年3月

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  • 新潟大学   医学部   医学科

    1996年4月 - 2002年3月

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所属学協会

 

論文

  • The impact of organ dysfunctions on mortality in patients with severe sepsis: A multicenter prospective observational study 査読

    Daisuke Kudo, Shigeki Kushimoto, Noriko Miyagawa, Tetsuya Sato, Masatsugu Hasegawa, Fumihito Ito, Sathoshi Yamanouchi, Hiroyuki Honda, Kohkichi Andoh, Hajime Furukawa, Yasuo Yamada, Yuta Tsujimoto, Manabu Okuyama

    Journal of Critical Care45   178 - 183   2018年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W.B. Saunders  

    Purpose: Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis. Material and methods: A prospective observational study was performed in 10 ICUs to obtain data from patients with severe sepsis. Multivariate analyses to examine in-hospital mortality were performed. Results: Data of 573 patients were analyzed. In-hospital mortality rate was 19.4% (111/573). The incidences of DIC, ARDS, and AKI were 58.4%, 18.7%, and 41.7%, while the associated mortality rates were 28.9%, 36.4%, and 31.8%, respectively. In multiple regression model, DIC (odds ratio 2.71, 95% confidence interval [CI] 1.45–5.27) and AKI stage 3 (odds ratio 1.98, 95% CI 1.07–3.63) were significantly associated with higher in-hospital all-cause mortality. DIC (hazard ratio 2.58, 95% CI 1.53–4.55) and AKI stage 3 (hazard ratio 1.73, 95% CI 1.07–2.80) were also significantly associated with longer survival durations. However, severe ARDS was not associated with these outcomes. Conclusions: DIC and AKI are frequent complications in patients with severe sepsis. In this study, DIC, and AKI stage 3 were independent risk factors of in-hospital mortality.

    DOI: 10.1016/j.jcrc.2018.03.011

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  • The mu opioid receptor activation does not affect ischemia-induced agonal currents in rat spinal ventral horn 査読

    Hiroyuki Honda, Hiroshi Baba, Tatsuro Kohno

    JOURNAL OF ANESTHESIA28 ( 6 ) 839 - 845   2014年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER JAPAN KK  

    Opioid-induced spastic paraplegia after transient spinal cord ischemia during aortic surgery has been reported. Opioids modulate neurotransmission through mu (mu) opioid receptors (MORs) in the spinal ventral horn. However, their effects during ischemic insult are not understood.
    The effects of the selective mu agonist [d-Ala(2),-N-Me-Phe(4), Gly(5)-ol]enkephalin (DAMGO) on ischemia-induced agonal currents were examined in the spinal lamina IX neurons of neonatal rats by using the whole-cell patch-clamp technique. Ischemia was simulated in vitro by oxygen/glucose deprivation.
    DAMGO (1 mu M) produced outward currents in similar to 60 % of spinal lamina IX neurons at a holding potential of -70 mV. Superfusion with ischemia-simulating medium elicited an agonal current. The latency was 457 +/- A 18 s. Despite its neuromodulatory effects, DAMGO did not significantly change the latencies of the agonal currents with (440 +/- A 23 s) or without (454 +/- A 33 s) DAMGO-induced currents.
    Activation of MORs does not influence ongoing ischemia-induced neuronal death. Our findings indicate that MOR agonist administration should be suitable as an anesthetic during aortic surgery.

    DOI: 10.1007/s00540-014-1829-3

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  • The Mu Opioid Receptor Modulates Neurotransmission in the Rat Spinal Ventral Horn 査読

    Hiroyuki Honda, Yasuhiko Kawasaki, Hiroshi Baba, Tatsuro Kohno

    ANESTHESIA AND ANALGESIA115 ( 3 ) 703 - 712   2012年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    BACKGROUND: Opioids inhibit excitatory neurotransmission and produce antinociception through mu opioid receptors (MORs). Although MORs are expressed in the spinal ventral horn, their functions and effects are largely unknown. Therefore, we examined the neuromodulatory effects of mu opioids in spinal lamina IX neurons at the cellular level.
    METHODS: The effects of the selective mu agonist [D-Ala(2),-N-Me-Phe(4), Gly(5)-ol]Jenkephalin (DAMGO) on synaptic transmission were examined in spinal lamina IX neurons of neonatal rats using the whole-cell patch-clamp technique.
    RESULTS: DAMGO produced outward currents in 56% of the lamina IX neurons recorded, with a 50% effective concentration of 0.1 mu M. Analysis of the current-voltage relationship revealed a reversal potential of approximately -86 mV. These currents were not blocked by tetrodotoxin but were inhibited by Ba2+ or a selective mu antagonist. Moreover, the currents were suppressed by the addition of Cs+ and tetraethylammonium or guanosine 5'-[beta-thi]diphosphate trilithium salt to the pipette solution. In addition, DAMGO decreased the frequency of spontaneous excitatory and inhibitory postsynaptic currents, and these effects were unaltered by treatment with tetrodotoxin.
    CONCLUSION: Our results suggest that DAMGO hyperpolarizes spinal lamina IX neurons by G protein-mediated activation of K+ channels after activation of MORs. Furthermore, activation of MORs on presynaptic terminals reduces both excitatory and inhibitory transmitter release. Although traditionally opioids are not thought to affect motor function, the present study documents neuromodulatory effects of mu opioids in spinal lamina IX neurons, suggesting that MORs can influence motor activity. (Anesth Analg 2012;115:703-12)

    DOI: 10.1213/ANE.0b013e318259393d

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  • Use of aortic occlusion balloon catheter for sacral giant cell tumor resection 査読

    Hiroyuki Honda, Takayuki Yoshida, Chieko Shibue, Hiroshi Baba

    Japanese Journal of Anesthesiology61 ( 6 ) 610 - 613   2012年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report 2 patients for whom anesthetic management using aortic occlusion balloon catheter (AOBC) was performed thrice. A 14-year-old boy and a 43-year-old man with sacral giant cell tumor underwent tumor resection. In both patients, transcatheter arterial embolization (TAE) was performed several times before the operation. Before the surgery, an AOBC was inserted via the right femoral artery. For tumor resection, the AOBC was inflated, and a slight decrease in hemorrhage was observed. The occlusion was maintained for 40-55 min, with a loss of 1,400-3,700 ml of blood. In case 1, moderate bleeding from the epidural venous plexus was observed. In case 2, packed red blood cell transfusion was needed, and the patient returned to surgery for hemostasis. Because the AOBC could not decrease the severity of venous hemorrhage, we expected increased hemorrhage with an increase in the extent of surgery. In addition, preoperative multiple TAE might lead to the development of collateral circulation around the sacrum and augment the amount of blood loss in that region. Although the AOBC could reduce intraoperative hemorrhage, uncontrollable bleeding may occur if the sacral giant cell tumor shows extensive dissemination.

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  • Effect of Xenon on Excitatory and Inhibitory Transmission in Rat Spinal Ventral Horn Neurons 査読

    Tomohiro Yamamoto, Hiroyuki Honda, Hiroshi Baba, Tatsuro Kohno

    ANESTHESIOLOGY116 ( 5 ) 1025 - 1034   2012年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background: The minimum alveolar concentration is determined in the spinal cord rather than in the brain. Xenon inhibits glutamatergic excitatory synaptic transmission in the dorsal horn neurons. However, its actions in the ventral horn neurons have not been investigated.
    Methods: The effects of 50 or 75% xenon on excitatory and inhibitory synaptic transmission were examined in the spinal lamina IX neurons of neonatal rats by using a whole cell patch clamp technique.
    Results: Fifty percent xenon inhibited the alpha-amino-3-hydroxy-5-methyl-4-isoxazole-4-propionic acid-induced currents (amplitudes = 72 +/- 9% and integrated area = 73 +/- 13% of the control values), and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-4-propionic acid receptor-mediated electrically evoked excitatory postsynaptic currents (amplitudes = 69 +/- 13% of the control values). Seventy-five percent xenon similarly inhibited alpha-amino-3-hydroxy-5-methyl-4-isoxazole-4-propionic acid-induced currents. However, xenon had no effect on the N-methyl-D-aspartate-induced currents or N-methyl-D-aspartate receptor-mediated electrically evoked excitatory postsynaptic currents. Xenon decreased the amplitude, but not the frequency, of miniature excitatory postsynaptic currents. There were no discernible effects on the currents induced by gamma-aminobutyric acid or glycine or on miniature inhibitory postsynaptic currents.
    Conclusions: Xenon inhibits alpha-amino-3-hydroxy-5-methyl-4-isoxazole-4-propionic acid receptor-mediated glutamatergic excitatory transmission in the spinal lamina IX neurons via a postsynaptic mechanism. In contrast, there are no substantial effects on N-methyl-D-aspartate receptor-mediated or inhibitory synaptic transmission. The suppressive effects on excitatory synaptic transmission in the ventral horn neurons partly account for the mechanism behind xenon's ability to produce immobility in response to noxious stimuli and to determine the minimum alveolar concentration.

    DOI: 10.1097/ALN.0b013e31825037a1

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  • Acute Airway Obstruction and Tracheal Laceration during Gastrostomy Placement in an Infant with Tracheoesophageal Fistula 査読

    Hideaki Ishii, Hiroyuki Honda, Tatsuro Kohno, Hiroshi Baba

    ANESTHESIOLOGY116 ( 2 ) 485 - 487   2012年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/ALN.0b013e31823cfaad

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  • Electrophysiological analysis of vulnerability to experimental ischemia in neonatal rat spinal ventral horn neurons 査読

    Hiroyuki Honda, Hiroshi Baba, Tatsuro Kohno

    NEUROSCIENCE LETTERS494 ( 2 ) 161 - 164   2011年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER IRELAND LTD  

    To clarify the vulnerability of spinal motoneurons to excitotoxicity, we analyzed the agonal current induced by experimental ischemia in ventral lamina IX neurons of spinal cord slices from neonatal rats by using whole-cell patch-clamp. Ischemia was simulated in vitro by oxygen/glucose deprivation. Super-fusion with ischemia-simulating medium elicited an agonal inward current, which was initially slow and then became rapid. We compared 8-, 9-, 10-, 11-, and 12-day postnatal rats and found age-dependent shortening of the latency of the rapid inward current. Furthermore, the membrane capacitance (Cm) and resting membrane potential (RMP) of the lamina IX neurons demonstrated significant negative correlations with the latency of the rapid inward current. Logistic regression analysis showed that postnatal age, Cm, and RMP were independent contributing factors to ischemic vulnerability. These results suggest that not only cell volume and ionic balance but also early postnatal maturation of the intracellular environment is vital for developing vulnerability to excitotoxicity. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/j.neulet.2011.03.003

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  • Epidural anesthesia with noninvasive positive pressure ventilation in a patient with compromised respiratory function 査読

    Hiroyuki Honda, Takayuki Honma, Hiroshi Baba

    Japanese Journal of Anesthesiology59 ( 4 ) 467 - 469   2010年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report successful epidural anesthetic management in a patient with severely impaired respiratory function. A 47-year-old woman (39 kg, 158 cm) was scheduled for right thoracoplasty. She had undergone fenestration surgery for empyema three months previously and required supplemental oxygen. Her vital capacity was 700 ml and forced expiratory volume in one second was 650 ml, indicating a severe restrictive pulmonary disorder. Hence, in order to avoid general anesthesia with tracheal intubation, we opted for epidural anesthesia. An epidural catheter was inserted in the T6-7 interspace and a bolus of 4.5 ml each of 1% mepivacaine and 1% ropivacaine was injected through the epidural catheter after a test dose. Ten minutes after the injection, the patient complained of difficulty in breathing and her oxygen saturation fell from 96% to 93%. We applied noninvasive positive pressure ventilation (NPPV) via a nasal mask to the patient, with the ventilator set at spontaneous/timed mode with inspiratory/expiratory positive airway pressure of 14/5 cmH2O. With this therapy, the patient's respiratory symptoms subsided rapidly and we could maintain adequate oxygenation and ventilation throughout the operation. We believe that epidural anesthesia with NPPV is a useful option for patients with compromised respiratory function.

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  • Internal jugular vein cannulation guided by ultrasonography in pediatric patients undergoing cardiovascular surgery 査読

    Sadahei Denda, Takashi Mochida, Miki Taneoka, Hiroyuki Honda, Yasushi Kitahara, Hironobu Nishimaki

    Japanese Journal of Anesthesiology56 ( 1 ) 69 - 73   2007年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Background: Central venous catheterization is essential for the anesthetic management of operations for congenital heart diseases. We prospectively examined the usefulness of ultrasonography in internal jugular vein catheterization in infants. Methods: Internal jugular vein cannulation was guided using an ultrasound image scanner in 96 pediatric cardiac patients. We investigated the rate of successful catheterizations, the number of attempts, the time from venipuncture to wire insertion, and the laterality of internal jugular vein diameters. Results: The success rate in all 96 patients was 95.8% with no carotid artery puncture. Patients younger than 12 month of age had success rates of 90%. In patients younger than 1 month of age and with weights less than 3.4kg, the success rate was 76.9%. The time from venipuncture to proper wire insertion in the first attempt (55.2%) was 50.8 ± 18.9s
    157.3± 56.4s for second attempt (18.8%)
    285.7±165.7s for third attempt (7.6%)
    346.0±98.4s for fourth attempt (5.5%)
    and 510.0±98.4s for fifth attempt (2.1%). The time requited was 1404.5±518.4s for attempts that required more than seven passes. Cannulations in four cases were unsuccessful because the image of the internal jugular vein was difficult to visualize. The left internal jugular vein diameter was larger than the right in 40 cases. In three unsuccessful cases, the diameter was less than 4.5 mm. Conclusions: Internal jugular vein cannulation guided by ultrasonography can be performed safely and quickly in pediatric patients.

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  • Prolonged loss of leg myogenic motor evoked potentials during thoracoabdominal aortic aneurysm repair, without postoperative paraplegia 査読

    Sadahei Denda, Miki Taneoka, Hiroyuki Honda, Yukiko Watanabe, Hidekazu Imai, Yasushi Kitahara

    Journal of Anesthesia20 ( 4 ) 314 - 318   2006年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    No postoperative paraplegia occurred in a patient whose leg myogenic motor evoked potentials (mMEPs) disappeared during thoracoabdominal aortic aneurysm repair. A 69-year-old man underwent resection and repair of a type III (Crawford classification) thoracoabdominal aneurysm. An epidural catheter was placed into the epidural space for epidural cooling, and a Swan-Ganz catheter was placed into the subarachnoid space for cerebrospinal fluid (CSF) drainage. Continuous CSF pressure and temperature measurement was carried out the day before surgery. The mMEPs gradually disappeared 10 min after proximal double aortic clamping and complete aortic transection. Selective perfusion of intercostal arteries was started about 20 min after the loss of the mMEPs, but the mMEPs were not restored. Possibly, spinal cord hyperemia, induced by selective perfusion of the intercostal vessels, narrowed the subarachnoid space so that CSF could not be satisfactorily drained during surgery. The spinal cord hyperemia may have decreased spinal function and suppressed the leg mMEPs. The persistence of the loss of mMEPs was undeniably due to the influence of the anesthetic agent or a perfusion disorder in the lower-extremity muscles. Of note, moderate spinal cord hypothermia and postoperative CSF drainage probably resulted in improved lower-limb motor function. © JSA 2006.

    DOI: 10.1007/s00540-006-0439-0

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講演・口頭発表等

  • 人工呼吸開始時の動的肺コンプライアンスの有用性

    本田博之

    第45回日本集中治療医学会  2018年2月22日 

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    記述言語:日本語   会議種別:ポスター発表  

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  • 敗血症における人工呼吸器早期離脱を予測する因子の検討

    本田博之

    第64回日本麻酔科学会  2017年6月9日 

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    記述言語:日本語   会議種別:ポスター発表  

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  • ドブタミンは敗血症性ARDSの予後を改善する可能性がある

    本田博之

    第44回日本集中治療医学会  2017年3月10日 

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    記述言語:日本語   会議種別:口頭発表(一般)  

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  • 従量式換気と従圧式換気はどのように選択されているか

    本田博之

    第43回日本集中治療医学会  2016年2月12日 

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    記述言語:日本語   会議種別:口頭発表(一般)  

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  • 中耳炎を原因としたレミエール症候群

    本田博之

    第43回日本救急医学会  2015年10月23日 

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    記述言語:日本語   会議種別:口頭発表(一般)  

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  • 先端技術でICUは変わるか? 招待

    本田博之

    第29回東北救急医学会  2015年5月30日 

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    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 鎮痛薬・鎮静薬処方の変化が患者予後に与える影響

    本田博之

    第41回日本集中治療医学会  2014年2月28日 

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    記述言語:日本語   会議種別:ポスター発表  

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  • 開心術後の危機的合併症を予測するICU入室時パラメータの検討

    本田博之

    第39回日本集中治療医学会  2012年2月29日 

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    記述言語:日本語   会議種別:ポスター発表  

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  • Mu opioid receptor agonist modulates synaptic transmission to neonatal rat spinal ventral horn neurons but does not affect neuronal deaht induced by experimental ischemia. 国際会議

    本田博之

    40th Annual Meeting of Neuroscience  2010年11月15日 

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    記述言語:英語   会議種別:ポスター発表  

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  • オピオイドは脊髄前角における虚血性神経細胞死を助長しない

    本田博之

    第57回日本麻酔科学会  2010年6月4日 

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    記述言語:日本語   会議種別:口頭発表(一般)  

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  • 生体肝移植ドナーの術後凝固機能と硬膜外麻酔の安全性

    本田博之

    第56回日本麻酔科学会  2009年8月18日 

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    記述言語:日本語   会議種別:ポスター発表  

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  • 当院救命救急センターにおける鎮静剤・鎮痛剤の使用状況

    本田博之

    第15回日本集中治療医学会関東甲信越地方会  2006年 

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    記述言語:日本語   会議種別:口頭発表(一般)  

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  • 術中の不適切な輸液により血糖値の異常を生じた2症例

    本田博之

    第43回日本麻酔科学会東京関東講師熱支部合同学術集会  2003年 

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    記述言語:日本語   会議種別:ポスター発表  

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  • 産婦人科手術術後に下肢の神経障害を生じた3症例

    本田博之

    第23回日本臨床麻酔学会  2003年 

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    記述言語:日本語   会議種別:ポスター発表  

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共同研究・競争的資金等の研究

  • 脊髄全角運動ニューロンにおける麻酔薬の作用と神経保護効果の検討

    2014年 - 2016年

    本田博之

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    担当区分:研究代表者  資金種別:競争的資金

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  • 麻酔薬による脊髄保護効果の電気生理学的解析

    2012年 - 2013年

    本田博之

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    担当区分:研究代表者  資金種別:競争的資金

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  • オピオイドの脊髄虚血に対する神経保護効果の電気生理学的解析

    2009年 - 2010年

    本田博之

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    担当区分:研究代表者  資金種別:競争的資金

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